|
Title
|
|
|
|
Serial pulmonary vascular resistance assessment in patients late after ventricular septal defect repair
| |
|
Author
|
|
|
|
| |
|
Abstract
|
|
|
|
| Background: The long-term evolution of pulmonary vascular resistance (PVR) after ventricular septal defect (VSD) repair is unknown. This study serially evaluated resting and exercise PVR after VSD repair in childhood. Methods: Patients were enrolled from the outpatient Adult Congenital Heart Disease clinic of the University Hospitals Leuven and compared to age- and gender-matched controls. Participants underwent resting and exercise echocardiography and cardiopulmonary exercise testing at baseline and follow-up. Total PVR was calculated as the ratio of mean pulmonary artery pressure (mPAP) to cardiac output (CO). The slope of the mPAP-CO curve (exercise PVR) was obtained using linear regression analysis. Results: Twenty-seven patients (mean age 31 7 years, 70% male) and 18 controls were included. Al baseline, patients had larger right ventricular (RV) end-diastolic areas (10 2 vs 9 1 CM2/F112, p 0.001) and lower tricuspid annular plane systolic excursion (TAPSE) (17 (17-19) vs 26 (22-28) mm, p < 0.001). After 1.1 (1.0-1.5) years follow-up, similar differences in RV areas and TAPSE were found. Patients reached lower peak workload and cardiac index compared to controls at each time point. Peak total PVR was higher (Baseline: 2.7 0.8 vs 2.2 0.3 mm Hg/L/min, p 0.005; Follow-up: 2.9- 0.9 vs 2.1 0.3 mm Hg/Ljmin, p < 0.001) and the mPAP-CO slope was steeper (Baseline: 22 0.8 vs 1.7 03 111111 Hg/Llnin, p 0.008; Follow-up: 2.5 0.9 vs 1.6 0.3111111 Ng(I./min, p <0.001) in patients. The niPAP-CO slope in patients correlated inversely with peak oxygen uptake (R 0.41 and 0.45, p 0.036 and 0.022, baseline and follow-up, respectively). Conclusion: Despite repair, VSD patients seem to show altered pulmonary hemodynamics and RV impairment at rest and exercise, supporting life-long follow-up. (C) 2018 Elsevier B.V. All rights reserved |
| |
|
Language
|
|
|
|
English
| |
|
Source (journal)
|
|
|
|
International journal of cardiology. - Amsterdam, 1981, currens
| |
|
Publication
|
|
|
|
Amsterdam
:
2019
| |
|
ISSN
|
|
|
|
0167-5273
| |
|
DOI
|
|
|
|
10.1016/J.IJCARD.2018.12.044
| |
|
Volume/pages
|
|
|
|
282
(2019)
, p. 38-43
| |
|
ISI
|
|
|
|
000460380800008
| |
|
Pubmed ID
|
|
|
|
30583924
| |
|
Full text (Publisher's DOI)
|
|
|
|
| |
|