Long-term pulmonary regurgitation following balloon valvuloplasty for pulmonary stenosis risk factors and relationship to exercise capacity and ventricular volume and function.
Objectives: This study sought to examine the prevalence and predictors of pulmonary regurgitation (PR) following balloon dilation (BD) for pulmonary stenosis (PS) and to investigate its impact on ventricular volume and function, and exercise tolerance.Background: Balloon pulmonary valvuloplasty reli...
| Publicado en: | Journal of the American College of Cardiology (JACC) Vol. 55; no. 10; pp. 1041 - 1048 |
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| Autores principales: | , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Mar2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105144298&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105144298 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07351097 20P jtl: Journal of the American College of Cardiology (JACC) issn: 07351097 maglogo: N pubinfo: dt: Mar2010 vid: 55 iid: 10 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 105144298 105144298 NLM20202522 2010593338 10.1016/j.jacc.2010.01.016 NLM20202522 PMC4235281 105144298 ppf: 1041 ppct: 7 formats: tig: atl: Long-term pulmonary regurgitation following balloon valvuloplasty for pulmonary stenosis risk factors and relationship to exercise capacity and ventricular volume and function. aug: au: Harrild DM Powell AJ Trang TX Geva T Lock JE Rhodes J McElhinney DB Harrild, David M Powell, Andrew J Tran, Trang X Trang, Trang X Geva, Tal Lock, James E Rhodes, Jonathan McElhinney, Doff B affil: Departments of Cardiology, Children's Hospital Boston, and Pediatrics, Harvard Medical School, Boston, Massachusetts, USA sug: subj: Balloon Dilatation Adverse Effects Cardiovascular System Physiology Exercise Test Hypertrophy, Right Ventricular Etiology Heart Valve Diseases Etiology Heart Valve Diseases Therapy Stroke Volume Physiology Adolescence Blood Pressure Physiology Carbon Dioxide Blood Child Child, Preschool Female Prospective Studies Heart Catheterization Human Hypertrophy, Right Ventricular Physiopathology Image Processing, Computer Assisted Infant Magnetic Resonance Imaging Methods Male Oxygen Blood Heart Valve Diseases Physiopathology Heart Valve Diseases Risk Factors Young Adult Adolescent: 13-18 years Child: 6-12 years Child, Preschool: 2-5 years Infant: 1-23 months Female Male ab: Objectives: This study sought to examine the prevalence and predictors of pulmonary regurgitation (PR) following balloon dilation (BD) for pulmonary stenosis (PS) and to investigate its impact on ventricular volume and function, and exercise tolerance.Background: Balloon pulmonary valvuloplasty relieves PS but can cause late PR. The sequelae of isolated PR are not well understood.Methods: Patients were at least 7 years of age and 5 years removed from BD, and had no other form of congenital heart disease or significant residual PS. Cardiac magnetic resonance imaging and exercise testing were performed prospectively to quantify PR fraction, ventricular volumes and function, and exercise capacity.Results: Forty-one patients underwent testing a median of 13.1 years after BD. The median PR fraction was 10%; 14 patients (34%) had PR fraction >15%; 7 (17%) had PR >30%. PR fraction was associated with age at dilation (ln-transformed, R = -0.47, p = 0.002) and balloon:annulus ratio (R = 0.57, p < 0.001). The mean right ventricular (RV) end-diastolic volume z-score was 1.8 +/- 1.9; RV dilation (z-score > or =2) was present in 14/35 patients (40%). PR fraction correlated closely with indexed RV end-diastolic volume (R = 0.79, p < 0.001) and modestly with RV ejection fraction (R = 0.50, p < 0.001). Overall, peak oxygen consumption (Vo(2)) (% predicted) was below average (92 +/- 17%, p = 0.006). Patients with PR fraction >15% had significantly lower peak Vo(2) than those with less PR (85 +/- 17% vs. 96 +/- 16%, p = 0.03).Conclusions: Mild PR and RV dilation are common in the long term following BD. A PR fraction >15% is associated with lower peak Vo(2), suggesting that isolated PR and consequent RV dilation are related to impaired exercise cardiopulmonary function. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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