Predictors of right atrial dilatation and long-term function after right ventricular outflow tract surgical repair: Quantification of restrictive physiology matters

被引:0
|
作者
Pijuan-Domenech, Maria Antonia [1 ,2 ,3 ,9 ]
Montserrat, Silvia [4 ]
Pineda, Victor [5 ]
Valente, Filipa [2 ,3 ]
Ferreira-Gonzalez, Ignacio [2 ,6 ]
Marsal, Josep-Ramon [2 ]
Castro-Alba, Miguel Angel [7 ]
Sureda-Barbosa, Carlos [7 ]
Miranda-Barrio, Berta [1 ,2 ,3 ]
Subirana-Domenech, Maria Teresa [1 ,8 ]
Dos-Subira, Laura [1 ,2 ,3 ]
Casaldaliga-Ferrer, Jaume [1 ]
机构
[1] Hosp Santa Creu & Sant Pau, Hosp Vall DHebron, Integrated Adult Congenital Heart Dis Unit, Passeig Vall DHebron 119-129, Barcelona 08035, Spain
[2] Hosp Univ Vall DHebron, Dept Cardiol, Barcelona, Spain
[3] Ctr Invest Red Enfermedades Cardiovasc CIBERCV, Madrid, Spain
[4] Hosp Clin Barcelona, Cardiovasc Inst, Dept Cardiol, Barcelona, Spain
[5] Hosp Univ Vall DHebron, Dept Radiol, Barcelona, Spain
[6] Ctr Invest Red Epidemiol CIBER ESP, Madrid, Spain
[7] Hosp Univ Vall DHebron, Dept Cardiovasc Surg, Barcelona, Spain
[8] Hosp Univ Santa Creu & St Pau, Dept Cardiol, Barcelona, Spain
[9] Vall dHebron Univ Hosp, Adult Congenital Cardiac Unit, Passeig Vall dHebron 119, Barcelona, Spain
来源
INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE | 2023年 / 11卷
关键词
Right diastolic dysfunction; Right ventricular outflow tract surgery; artery; Right atrium area; Right atrium function; Restrictive physiology; TETRALOGY; HEART;
D O I
10.1016/j.ijcchd.2022.100435
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Right ventricular (RV) diastolic dysfunction in patients with a surgically-repaired RV outflow tract (RVOT) obstruction merits further studies. Right atrial (RA) dilation and function may be related to (RV) diastolic dysfunction in this setting. The end-diastolic forward flow (EDFF) in the pulmonary artery (PA) has been suggested as a non-invasive marker of poor RV compliance, however, there is controversy regarding its true significance; EDFF quantification may help elucidate this controversy. Objective: to study predictors of RA enlargement and dysfunction in patients with a surgically-repaired RVOT obstruction and its relationship with quantitative EDFF. Methods: In 81 consecutive patients (mean age: 37.5 (+/- 7) years), transthoracic echocardiography (Echo) and cardiac magnetic resonance (CMR) were performed. Echo parameters: RA size (indexed RA area (iRAA)), RA function (RA global strain (RAGS)) and maximum EDFF velocity-time integral (VTI-EDFF) obtained during a whole respiratory cycle. CMR-indexed RA area (imRAA) was also obtained. Patients were divided into three groups according to iRAA, imRAA and RAGS; bivariate analysis was performed. A multivariate model was then applied using variables that were found to be statistically significant in the bivariate analysis. Results: Upon multivariate analysis, higher VTI-EDFF values and the presence of significant tricuspid regurgitation proved to be independent factors associated with increased iRAA and imRAA and lower RAGS, whereas RV volumes, function and pulmonary regurgitant fraction were not. Conclusion: VTI-EDFF linearly correlated with the degree of RA dilation and deformation; EDFF quantification as against qualitative assessment may be considered a non-invasive tool for diastolic RV dysfunction.
引用
收藏
页数:8
相关论文
共 50 条
  • [41] Confounding Effects of Right Ventricular Outflow Tract Obstruction on the Impact of Pulmonary Regurgitation on Right Ventricular Size and Function in Patients After Repair of Tetralogy of Fallot
    Spiewak, Mateusz
    Biernacka, Elzbieta K.
    Malek, Lukasz A.
    Misko, Jolanta
    Petryka, Joanna
    Kowalski, Miroslaw
    Milosz, Barbara
    Zabicka, Magdalena
    Ruzyllo, Witold
    CIRCULATION, 2010, 122 (21)
  • [42] Right ventricular outflow tract obstruction as a confounding factor in the assessment of impact of pulmonary regurgitation on right ventricular size and function after repair of tetralogy of Fallot
    Spiewak, M.
    Biernacka, E. K.
    Malek, L. A.
    Misko, J.
    Petryka, J.
    Kowalski, M.
    Milosz, B.
    Zabicka, M.
    Hoffman, P.
    Ruzyllo, W.
    EUROPEAN HEART JOURNAL, 2010, 31 : 929 - 930
  • [43] Right Atrial Mechanics Long-Term after Biventricular Repair of Pulmonary Atresia or Stenosis with Intact Ventricular Septum
    To, Ashley Hoi-man
    Lai, Clare Tik-man
    Wong, Sophia J.
    Cheung, Yiu-fai
    ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, 2016, 33 (04): : 586 - 595
  • [44] Long-Term Outcome After Ablation of Right Atrial Tachyarrhythmias After the Surgical Repair of Congenital and Acquired Heart Disease
    Anguera, Ignasi
    Dallaglio, Paolo
    Macias, Rosa
    Jimenez-Candil, Javier
    Peinado, Rafael
    Garcia-Seara, Javier
    Fe Arcocha, Mari
    Herreros, Benito
    Quesada, Aurelio
    Hernandez-Madrid, Antonio
    Alvarez, Miguel
    Filgueiras, David
    Matia, Roberto
    Cequier, Angel
    Sabate, Xavier
    AMERICAN JOURNAL OF CARDIOLOGY, 2015, 115 (12): : 1705 - 1713
  • [45] Left Ventricular Outflow Tract to Right Atrial Fistula After Aortic Valve Replacement
    Subramaniam, Kathirvel
    Wei, Lawrence
    JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2009, 23 (03) : 360 - 363
  • [46] Long-term results of right ventricular outflow tract reconstruction in neonatal cardiac surgery: Options and outcomes
    Kaza, Aditya K.
    Lim, Hong-Gook
    Dibardino, Daniel J.
    Bautista-Hernandez, Victor
    Robinson, Joshua
    Allan, Catherine
    Laussen, Peter
    Fynn-Thompson, Francis
    Bacha, Emile
    del Nido, Pedro J.
    Mayer, John E., Jr.
    Pigula, Frank A.
    JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2009, 138 (04): : 911 - 916
  • [47] Does restrictive right ventricular physiology in the early postoperative period predict subsequent right ventricular restriction after repair of tetralogy of Fallot?
    Norgård, G
    Gatzoulis, MA
    Josen, M
    Cullen, S
    Redington, AN
    HEART, 1998, 79 (05) : 481 - 484
  • [48] LONG-TERM SEQUENTIAL HEMODYNAMIC EVALUATION OF RIGHT VENTRICULAR OUTFLOW TRACT RECONSTRUCTION USING A VALVE MECHANISM
    IONESCU, MI
    TANDON, AP
    MACARTNEY, FJ
    ANNALS OF THORACIC SURGERY, 1979, 27 (05): : 426 - 434
  • [49] THE RIGHT VENTRICULAR OUTFLOW TRACT AS AN ALTERNATIVE PERMANENT PACING SITE - LONG-TERM FOLLOW-UP
    BARIN, ES
    JONES, SM
    WARD, DE
    CAMM, AJ
    NATHAN, AW
    PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1991, 14 (01): : 3 - 6
  • [50] RIGHT VENTRICULAR OUTFLOW TRACT (RVOT) AFTER INTRACARDIAC REPAIR OF TETRALOGY OF FALLOT (TF)
    HUTH, C
    LANGENBECKS ARCHIV FUR CHIRURGIE, 1985, 366 : 657 - 657