Isolated pulmonary regurgitation causes decreased right ventricular longitudinal function and compensatory increased septal pumping in a porcine model
| Autor: | Marcus Carlsson, Niels Vejlstrup, Sigurdur S Stephensen, Håkan Arheden, Lars Søndergaard, Mads Ersbøll, Sascha Kopic, Philipp Bonhoeffer, Einar Heiberg |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Cardiac magnetic resonance Swine Physiology Ventricular Dysfunction Right medicine.medical_treatment Ventricular Septum 030204 cardiovascular system & hematology Cardiovascular Physiology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Cardiac magnetic resonance imaging Internal medicine Pulmonary Valve Replacement Regular Paper medicine Journal Article Animals Tetralogy of Fallot medicine.diagnostic_test business.industry mitral annular plane systolic excursion (MAPSE) Stent tricuspid annular plane systolic excursion Stroke volume medicine.disease Pulmonary Valve Insufficiency Cardiac surgery medicine.anatomical_structure Ventricle Pulmonary valve Cardiology ventricular function business |
| Zdroj: | Kopic, S, Stephensen, S S, Heiberg, E, Arheden, H, Bonhoeffer, P, Ersbøll, M, Vejlstrup, N, Søndergaard, L & Carlsson, M 2017, ' Isolated pulmonary regurgitation causes decreased right ventricular longitudinal function and compensatory increased septal pumping in a porcine model ', Acta Physiologica , vol. 221, no. 3, pp. 163-173 . https://doi.org/10.1111/apha.12904 Acta Physiologica (Oxford, England) |
| Popis: | AIM: Longitudinal ventricular contraction is a parameter of cardiac performance with predictive power. Right ventricular (RV) longitudinal function is impaired in patients with free pulmonary regurgitation (PR) following corrective surgery for Tetralogy of Fallot (TOF). It remains unclear whether this is a consequence of the surgical repair, or whether it is inherent to PR. The aim of this study was to assess the relationship between longitudinal, lateral and septal pumping in a porcine model of isolated PR.METHODS: Piglets were divided into a control (n = 8) group and a treatment (n = 12) group, which received a stent in the pulmonary valve orifice, inducing PR. After 2-3 months, animals were subjected to cardiac magnetic resonance imaging. A subset of animals (n = 6) then underwent percutaneous pulmonary valve replacement (PPVR) with follow-up 1 month later. Longitudinal, lateral and septal contributions to stroke volume (SV) were quantified by measuring volumetric displacements from end-diastole to end-systole in the cardiac short axis and long axis.RESULTS: PR resulted in a lower longitudinal contribution to RV stroke volume, compared to controls (60.0 ± 2.6% vs. 73.6 ± 3.8%; P = 0.012). Furthermore, a compensatory increase in septal contribution to RVSV was observed (11.0 ± 1.6% vs. -3.1 ± 1.5%; P < 0.0001). The left ventricle (LV) showed counter-regulation with an increased longitudinal LVSV. Changes in RV longitudinal function were reversed by PPVR.CONCLUSION: These findings suggest that PR contributes to decreased RV longitudinal function in the absence of scarring from cardiac surgery. Measurement of longitudinal RVSV may aid risk stratification and timing for interventional correction of PR in TOF patients. |
| Databáze: | OpenAIRE |
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