Effect of Right Ventricular Outflow Tract Obstruction On Right Ventricular Volumes and Exercise Capacity in Patients With Repaired Tetralogy of Fallot
Autor: | Joost P. van Melle, Dirk J. van Veldhuisen, Tineke P. Willems, Ymkje J. van Slooten, Beatrijs Bartelds, Rolf M. F. Berger, Hendrik G. Freling, Petronella G. Pieper |
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Přispěvatelé: | Cardiovascular Centre (CVC), Vascular Ageing Programme (VAP) |
Jazyk: | angličtina |
Rok vydání: | 2014 |
Předmět: |
Adult
Male medicine.medical_specialty IMPACT Heart Ventricles MULTICENTER Right ventricular outflow tract obstruction STENOSIS Ventricular Outflow Obstruction INSUFFICIENCY Cardiac magnetic resonance imaging Pulmonary Valve Replacement Internal medicine medicine Humans In patient Exercise Tetralogy of Fallot Retrospective Studies medicine.diagnostic_test PULMONARY VALVE-REPLACEMENT business.industry Exercise capacity Middle Aged medicine.disease Magnetic Resonance Imaging Surgery PREDICTS CONGENITAL HEART-DISEASE Stenosis Echocardiography Child Preschool Rv function GROWING SWINE Cardiology Exercise Test Ventricular Function Right RISK-FACTORS Female Cardiology and Cardiovascular Medicine business |
Zdroj: | American Journal of Cardiology, 113(4), 719-723. EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC |
ISSN: | 0002-9149 |
Popis: | 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)), p0.05. 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%), p0.001. 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. |
Databáze: | OpenAIRE |
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