Improved early ventricular performance with a right ventricle to pulmonary artery conduit in stage 1 palliation for hypoplastic left heart syndrome: evidence from strain Doppler echocardiography

被引:50
作者
Hughes, ML
Shekerdemian, LS
Brizard, CP
Penny, DJ
机构
[1] Royal Childrens Hosp, Dept Cardiol, Melbourne, Vic 3052, Australia
[2] Royal Childrens Hosp, Dept Intens Care, Melbourne, Vic 3052, Australia
[3] Royal Childrens Hosp, Dept Cardiac Surg, Melbourne, Vic 3052, Australia
关键词
D O I
10.1136/hrt.2003.016675
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To quantify non-invasively right ventricular ( RV) performance in infants after stage 1 palliation for hypoplastic left heart syndrome (HLHS). Design: Prospective, observational study with two dimensional and strain Doppler echocardiography. Setting: Single tertiary paediatric cardiology centre. Patients: Convenience sample of nine consecutive infants with HLHS. Four whose surgery involved a systemic to pulmonary artery (S-PA) shunt were compared with five whose surgery incorporated a right ventricle to pulmonary artery (RV-PA) conduit. Methods: Basal RV free wall longitudinal strain rate, systolic strain ( e), and RV percentage area change were calculated during a single assessment between 27 - 50 days after surgery. Results: Cardiopulmonary bypass time was longer in patients who underwent RV-PA ( 226 ( 30) minutes v 181 (18) minutes, p = 0.03), but cross clamp time, duration of ventilation, and inotrope use did not differ. Two patients in the S-PA group died, on days 29 and 60 after surgery. Peak systolic strain rate (-1.24 (0.19)/ s v -0.91 (0.21)/ s, p = 0.048), peak epsilon (-17.8 (1.8)% v - 13.4 (2.0)%, p = 0.01), and RV percentage area change ( 56 ( 6)% v 25 ( 6)%, p, 0.01) were all greater among RV-PA patients. These indices also tended to be greater in survivors as a group. Ventricular loading conditions ( oxygen saturations, diuretic treatment, and blood pressure) were similar in both groups. Conclusion: Strain Doppler echocardiography shows improved RV longitudinal systolic contractility in patients during convalescence after the RV-PA modification of stage 1 palliation for HLHS compared with those with an S-PA shunt.
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页码:191 / 194
页数:4
相关论文
共 11 条
[1]   Two-dimensional echocardiographic assessment of right ventricular function as a predictor of outcome in hypoplastic left heart syndrome [J].
Altmann, K ;
Printz, BF ;
Solowiejczyk, DE ;
Gersony, WM ;
Quaegebeur, J ;
Apfel, HD .
AMERICAN JOURNAL OF CARDIOLOGY, 2000, 86 (09) :964-968
[2]   STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT [J].
BLAND, JM ;
ALTMAN, DG .
LANCET, 1986, 1 (8476) :307-310
[3]  
D'hooge J, 2000, Eur J Echocardiogr, V1, P154, DOI 10.1053/euje.2000.0031
[4]   Resting coronary flow and coronary flow reserve in human infants after repair or palliation of congenital heart defects as measured by positron emission tomography [J].
Donnelly, JP ;
Raffel, DM ;
Shulkin, BL ;
Corbett, JR ;
Bove, EL ;
Mosca, RS ;
Kulik, TJ .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1998, 115 (01) :103-110
[5]   Quantitative assessment of intrinsic regional myocardial deformation by Doppler strain rate echocardiography in humans - Validation against three-dimensional tagged magnetic resonance imaging [J].
Edvardsen, T ;
Gerber, BL ;
Garot, J ;
Bluemke, DA ;
Lima, JAC ;
Smiseth, OA .
CIRCULATION, 2002, 106 (01) :50-56
[6]  
Kimball T R, 1996, J Am Soc Echocardiogr, V9, P629, DOI 10.1016/S0894-7317(96)90058-9
[7]   The modified Norwood palliation on a beating heart [J].
Kishimoto, H ;
Kawahira, Y ;
Kawata, H ;
Miura, T ;
Iwai, S ;
Mori, T .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1999, 118 (06) :1130-1132
[8]   A CONCORDANCE CORRELATION-COEFFICIENT TO EVALUATE REPRODUCIBILITY [J].
LIN, LI .
BIOMETRICS, 1989, 45 (01) :255-268
[9]   HYPOPLASTIC LEFT HEART SYNDROME - EXPERIENCE WITH PALLIATIVE SURGERY [J].
NORWOOD, WI ;
KIRKLIN, JK ;
SANDERS, SP .
AMERICAN JOURNAL OF CARDIOLOGY, 1980, 45 (01) :87-91
[10]  
Pizarro C, 2002, CIRCULATION, V106, P394