Diagnosis and treatment of right ventricular dysfunction in congenital heart disease
| Autor: | Daniel Bernstein, Pieter De Meester, Werner Budts, Martin Koestenberger, Alexander Van De Bruaene, Béatrice Santens, Georg Hansmann, Michele D'Alto, Sushma Reddy |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
PULMONARY ARTERIAL-HYPERTENSION
medicine.medical_specialty Cardiac & Cardiovascular Systems Heart disease SYSTEMIC RIGHT VENTRICLE Hemodynamics systemic right ventricular CARDIAC TROPONIN-T 030204 cardiovascular system & hematology Review Article on Right Ventricular Dysfunction 03 medical and health sciences 0302 clinical medicine ANGIOTENSIN RECEPTOR BLOCKADE HIGH-SENSITIVITY TROPONIN Internal medicine heart failure (HF) Medicine cardiovascular diseases 030212 general & internal medicine AMERICAN SOCIETY EUROPEAN ASSOCIATION Science & Technology Troponin T treatment of heart failure business.industry Congenital heart disease (CHD) GROWTH-DIFFERENTIATION FACTOR-15 medicine.disease CORRECTED TRANSPOSITION Blood pressure medicine.anatomical_structure BRAIN NATRIURETIC PEPTIDE Ventricle Heart failure Cardiovascular System & Cardiology Cardiology right ventricular dysfunction GDF15 Cardiology and Cardiovascular Medicine business Life Sciences & Biomedicine Perfusion |
| Zdroj: | Cardiovasc Diagn Ther |
| ISSN: | 2223-3660 2223-3652 |
| DOI: | 10.21037/cdt-20-370 |
| Popis: | Right ventricular (RV) function is important for clinical status and outcomes in children and adults with congenital heart disease (CHD). In the normal RV, longitudinal systolic function is the major contributor to global RV systolic function. A variety of factors contribute to RV failure including increased pressure- or volume-loading, electromechanical dyssynchrony, increased myocardial fibrosis, abnormal coronary perfusion, restricted filling capacity and adverse interactions between left ventricle (LV) and RV. We discuss the different imaging techniques both at rest and during exercise to define and detect RV failure. We identify the most important biomarkers for risk stratification in RV dysfunction, including abnormal NYHA class, decreased exercise capacity, low blood pressure, and increased levels of NTproBNP, troponin T, galectin-3 and growth differentiation factor 15. In adults with CHD (ACHD), fragmented QRS is independently associated with heart failure (HF) symptoms and impaired ventricular function. Furthermore, we discuss the different HF therapies in CHD but given the broad clinical spectrum of CHD, it is important to treat RV failure in a disease-specific manner and based on the specific alterations in hemodynamics. Here, we discuss how to detect and treat RV dysfunction in CHD in order to prevent or postpone RV failure. ispartof: CARDIOVASCULAR DIAGNOSIS AND THERAPY vol:10 issue:5 pages:1625-1645 ispartof: location:China status: published |
| Databáze: | OpenAIRE |
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