Abstract | BACKGROUND: METHODS: Eighteen r-TOF patients (median age 31.9 years, range 16.2-60.1) with severe PR and 10 healthy controls (median age 40.6 years, range 23.9-51.8) completed staged DS-MR (baseline, 10 and 20 μg/kg/min) with ventricular volumetry and pulmonary flow quantification. Comparative analysis involved 3-way ANOVA, t-test, regression analysis, and coefficient of variance. RESULTS: All controls had significant increase of ejection fraction (EF) at each stress level for both ventricles (normal contractile reserve, all p<0.05). In r-TOF patients (RV-EDV 126 ± 27 ml/m(2), RV-EF 55 ± 7%, LV-EF 58 ± 6%, PR-fraction 43 ± 15%), low-dose DS-MR at 10 μg/kg/min demonstrated normal biventricular contractile reserve as seen in volunteers. On increase from 10 to 20 μg/kg/min a subgroup showed worsening ejection fraction (n=8, p<0.05), mainly due to lack of reduction or even increase of RV-ESV, while the remainder responded with further reduction of RV-ESV and RV-EDV (n=10, p<0.05) and a non-significant trend to increased EF. This different response could not be predicted at baseline. CONCLUSIONS: In r-TOF patients with chronic PR, DS-MR at 10 μg/kg/min showed normal biventricular systolic response compared with controls. Increase to 20 μg/kg/min provoked abnormal RV-ESV response in some r-TOF patients, suggesting presence of ventricular systolic dysfunction not evident at rest.
|
Authors | Victoria Parish, Israel Valverde, Shelby Kutty, Catherine Head, Shakeel A Qureshi, Samir Sarikouch, Gerald Greil, Tobias Schaeffter, Reza Razavi, Philipp Beerbaum |
Journal | International journal of cardiology
(Int J Cardiol)
Vol. 166
Issue 1
Pg. 96-105
(Jun 05 2013)
ISSN: 1874-1754 [Electronic] Netherlands |
PMID | 22154014
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
|
Copyright | Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All rights reserved. |
Topics |
- Adolescent
- Adult
- Chronic Disease
- Echocardiography, Stress
(methods)
- Exercise Test
(methods)
- Female
- Humans
- Magnetic Resonance Imaging
(methods)
- Male
- Middle Aged
- Prospective Studies
- Pulmonary Valve Insufficiency
(diagnosis, physiopathology)
- Tetralogy of Fallot
(physiopathology, surgery)
- Young Adult
|