期刊
EUROPEAN HEART JOURNAL
卷 33, 期 19, 页码 2434-2441出版社
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehs200
关键词
Exercise physiology; Right ventricular outflow tract dysfunction; Percutaneous pulmonary valve implantation; Congenital heart disease; Exercise stress magnetic resonance imaging
资金
- European Union (Health e Child Initiative) [027749]
- British Heart Foundation (BHF) [FS/08/012/24454]
- National Institute of Health Research (NIHR), UK [SRF/08/01/018]
- British Heart Foundation [FS/08/012/24454] Funding Source: researchfish
To assess the impact of relief of pulmonary stenosis (PS) and pulmonary regurgitation (PR) by percutaneous pulmonary valve implantation (PPVI) on biventricular function during exercise stress. Seventeen patients, who underwent PPVI for PS or PR, were included. Magnetic resonance imaging was performed at rest and during supine exercise stress pre- and within 1-month post-PPVI, using a radial k t SENSE real-time sequence. In patients with PS (n 9), there was no reserve in right ventricular (RV) ejection fraction (EF) in response to exercise prior to PPVI (48.2 12.1 at rest vs. 48.4 14.8 during exercise, P 0.87). Post-PPVI, reserve in RVEF in response to exercise was re-established (53.4 15.0 at rest vs. 59.6 17.3 during exercise, P 0.003) with improvement in left ventricular stroke volume (LVSV) (45.4 6.2 mL/m(2) at rest vs. 52.8 8.8 mL/m(2) during exercise, P 0.001). In patients with PR prior to PPVI (n 8), LVSV during exercise increased (43.0 8.5 vs. 54.3 6.6 mL/m(2), P 0.001) due to reduction in PR fraction during exercise (29.2 5.2 vs. 13.6 6.1, P 0.001). After PPVI, LVSV increased from rest to exercise (48.4 8.8 vs. 57.2 8.1 mL/m(2), P 0.001) due to improved RVEF (45.5 8.3 vs. 50.4 6.9, P 0.001). There was a significantly higher increase in LVSV at exercise from pre- to post-PPVI in PS patients than in PR patients (LVSV 8.2 4.1 vs. 2.9 4.1 mL/m(2), P 0.01). The reduction in the RV outflow tract gradient correlated significantly with the improvement in LVSV during exercise (r 0.73, P 0.001). Percutaneous pulmonary valve implantation in patients with PS leads to restoration of reserve in RVEF during exercise stress. In patients with PR, SV augmentation improves only mildly post-PPVI. Improvement in SV augmentation during exercise stress after PPVI is dependent mainly on afterload reduction.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据