Effect of right ventricular outflow tract obstruction on right ventricular volumes and exercise capacity in patients with repaired tetralogy of fallot.

Autor: Freling HG; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands., Willems TP; Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., van Melle JP; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., van Slooten YJ; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands; Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Bartelds B; Department of Pediatric Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Berger RM; Department of Pediatric Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., van Veldhuisen DJ; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Pieper PG; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: p.g.pieper@umcg.nl.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2014 Feb 15; Vol. 113 (4), pp. 719-23. Date of Electronic Publication: 2013 Nov 25.
DOI: 10.1016/j.amjcard.2013.10.049
Abstrakt: Patients with tetralogy of Fallot and combined right ventricular outflow tract obstruction (RVOTO) and pulmonary regurgitation (PR) have a less dilated right ventricular (RV) and better RV function compared with patients without RVOTO. It is not known whether RVOTO is associated with improved exercise capacity. We compared cardiac magnetic resonance imaging, echocardiography, and exercise tests in 12 patients with RVOTO (Doppler peak RVOT gradient ≥30 mm Hg) and 30 patients without RVOTO. RV end-systolic and end-diastolic volumes were smaller in patients with RVOTO compared with patients without RVOTO (50 ± 16 vs 64 ± 18 ml/m(2) and 117 ± 24 vs 135 ± 28 ml/m(2), respectively) and patients with RVOTO had a higher RV mass (52 ± 14 vs 42 ± 11 ml/m(2)), p <0.05. RV ejection fraction was marginally significantly different between both groups (58 ± 8% vs 53 ± 7%), p = 0.051. Degree of PR, left ventricular volumes, and function did not differ significantly between both groups. Peak oxygen uptake in patients with RVOTO was significantly lower (25 ± 3 vs 32 ± 8 ml/kg/min) than in patients without RVOTO, as was the percentage of predicted peak oxygen uptake (63 ± 7% vs 79 ± 14%), p <0.001. Multivariate analysis showed that the peak RVOT gradient was the only independent predictor of exercise capacity. In conclusion, exercise capacity is lower in patients with RVOTO compared with those without RVOTO despite a less dilated RV and comparable degree of PR. Therefore, exercise capacity may be of importance and should additionally be taken in consideration to RV volumes and function in patients with tetralogy of Fallot and PR.
(Copyright © 2014 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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