The Impact of the Left Ventricle on Right Ventricular Function and Clinical Outcomes in Infants with Single–Right Ventricle Anomalies up to 14 Months of Age
| Autor: | Sonal T. Owens, Jami C. Levine, Steven M. Schwartz, Peter C. Frommelt, Alan B. Lewis, Jeanne M. Baffa, Andreea Dragulescu, Meryl S. Cohen, Carolyn L. Taylor, Heather T. Henderson, Catherine D. Krawczeski, Gul Dudlani, Victor Zak, Wyman W. Lai, Rachel T. McCandless, Richard G. Ohye, Timothy C. Slesnick, Nicholas Dagincourt, Peter J. Bartz |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Heart Ventricles Diastole Regurgitation (circulation) 030204 cardiovascular system & hematology Norwood Procedures Article Hypoplastic left heart syndrome 03 medical and health sciences 0302 clinical medicine Internal medicine Hypoplastic Left Heart Syndrome medicine Humans Radiology Nuclear Medicine and imaging Heart transplantation Ejection fraction business.industry Palliative Care Infant Newborn Infant medicine.disease Prognosis Stenosis medicine.anatomical_structure 030228 respiratory system Ventricle Echocardiography Cardiology Ventricular Function Right Norwood procedure Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Popis: | Background Children with single–right ventricle anomalies such as hypoplastic left heart syndrome (HLHS) have left ventricles of variable size and function. The impact of the left ventricle on the performance of the right ventricle and on survival remains unclear. The aim of this study was to identify whether left ventricular (LV) size and function influence right ventricular (RV) function and clinical outcome after staged palliation for single–right ventricle anomalies. Methods In the Single Ventricle Reconstruction trial, echocardiography-derived measures of LV size and function were compared with measures of RV systolic and diastolic function, tricuspid regurgitation, and outcomes (death and/or heart transplantation) at baseline (preoperatively), early after Norwood palliation, before stage 2 palliation, and at 14 months of age. Results Of the 522 subjects who met the study inclusion criteria, 381 (73%) had measurable left ventricles. The HLHS subtype of aortic atresia/mitral atresia was significantly less likely to have a measurable left ventricle (41%) compared with the other HLHS subtypes: aortic stenosis/mitral stenosis (100%), aortic atresia/mitral stenosis (96%), and those without HLHS (83%). RV end-diastolic and end-systolic volumes were significantly larger, while diastolic indices suggested better diastolic properties in those subjects with no left ventricles compared with those with measurable left ventricles. However, RV ejection fraction was not different on the basis of LV size and function after staged palliation. Moreover, there was no difference in transplantation-free survival to Norwood discharge, through the interstage period, or at 14 months of age between those subjects who had measurable left ventricles compared with those who did not. Conclusions LV size varies by anatomic subtype in infants with single–right ventricle anomalies. Although indices of RV size and diastolic function were influenced by the presence of a left ventricle, there was no difference in RV systolic function or transplantation-free survival on the basis of LV measures. |
| Databáze: | OpenAIRE |
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