Atrioventricular Area Difference Aids Diastolic Filling in Patients with Repaired Tetralogy of Fallot.

Autor: Johansson M; Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.; Department of Clinical Physiology, Skåne University Hospital, 22185, Lund, Sweden.; Department of Pediatric Anesthesia and Intensive Care, Skåne University Hospital, Lund, Sweden.; Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden., Hedström E; Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.; Department of Clinical Physiology, Skåne University Hospital, 22185, Lund, Sweden.; Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.; Department of Radiology, Skåne University Hospital, Lund, Sweden., Steding-Ehrenborg K; Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.; Department of Clinical Physiology, Skåne University Hospital, 22185, Lund, Sweden., Bhat M; Department of Clinical Sciences Lund, Lund University, Lund, Sweden.; Pediatric Cardiology, Children's Heart Centre, Skåne University Hospital, Lund, Sweden., Liuba P; Department of Clinical Sciences Lund, Lund University, Lund, Sweden.; Pediatric Cardiology, Children's Heart Centre, Skåne University Hospital, Lund, Sweden., Arheden H; Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.; Department of Clinical Physiology, Skåne University Hospital, 22185, Lund, Sweden., Sjöberg P; Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden. pia.sjoberg@med.lu.se.; Department of Clinical Physiology, Skåne University Hospital, 22185, Lund, Sweden. pia.sjoberg@med.lu.se.
Jazyk: angličtina
Zdroj: Pediatric cardiology [Pediatr Cardiol] 2024 May 28. Date of Electronic Publication: 2024 May 28.
DOI: 10.1007/s00246-024-03508-7
Abstrakt: A hydraulic force aids diastolic filling of the left ventricle (LV) and is proportional to the difference in short-axis area between the left ventricle and atrium; the atrioventricular area difference (AVAD). Patients with repaired Tetralogy of Fallot (rToF) and pulmonary regurgitation (PR) have reduced LV filling which could lead to a negative AVAD and a hydraulic force impeding diastolic filling. The aim was to assess AVAD and to determine whether the hydraulic force aids or impedes diastolic filling in patients with rToF and PR, compared to controls. Twelve children with rToF (11.5 [9-13] years), 12 pediatric controls (10.5 [9-13] years), 12 adults with rToF (21.5 [19-27] years) and 12 adult controls (24 [21-29] years) were retrospectively included. Cine short-axis images were acquired using cardiac magnetic resonance imaging. Atrioventricular area difference was calculated as the largest left ventricular short-axis area minus the largest left atrial short-axis area at beginning of diastole and end diastole and indexed to height (AVADi). Children and adults with rToF and PR had higher AVADi (0.3 cm 2 /m [- 1.3 to 0.8] and - 0.6 [- 1.5 to - 0.2]) at beginning of diastole compared to controls (- 2.7 cm 2 /m [- 4.9 to - 1.7], p = 0.015) and - 3.3 cm 2 /m [- 3.8 to - 2.8], p = 0.017). At end diastole AVADi did not differ between patients and controls. Children and adults with rToF and pulmonary regurgitation have an atrioventricular area difference that do not differ from controls and thus a net hydraulic force that contributes to left ventricular diastolic filling, despite a small underfilled left ventricle due to pulmonary regurgitation.
(© 2024. The Author(s).)
Databáze: MEDLINE
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