کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2933327 1576321 2009 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Right ventricular contractile reserve in mitral stenosis: Implications on hemodynamic burden and clinical outcome
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Right ventricular contractile reserve in mitral stenosis: Implications on hemodynamic burden and clinical outcome
چکیده انگلیسی

BackgroundWe investigated whether isovolumic acceleration (IVA) under inotropic stimulation as a means of right ventricular (RV) contractile reserve, is a surrogate for hemodynamic burden and has prognostic value in patients with mitral stenosis (MS).MethodsThirty-one pure MS patients and 20 controls underwent cardiac catheterization, exercise test, and dobutamine stress echocardiography. RV fractional area change (FAC), + dP/dt/Pmax, RV tissue Doppler indices (isovolumic contraction [IVC] and systolic [S] velocity, and IVA) were measured. Patients were followed-up for the occurrence of cardiac adverse events.ResultsInotropic modulation unmasked statistically significant differences regarding magnitude of changes in IVA, IVC, S, and + dP/dt/Pmax, but not RV FAC. Inability to increase IVA more than 6.5 m/s2 was the only independent determinant of pulmonary capillary wedge pressure ≥ 18 mm Hg (P = .004). Although MS severity did not predict the RV contractile reserve and pulmonary artery pressure (PAP) behavior during inotropic stimulation, the RV contractile reserve was related to the degree of systolic PAP. IVA increases of < 3.4 m/s2 had 86% sensitivity and 75% specificity to predict unfavorable outcomes during long-term follow-up (20 ± 8 months).ConclusionRV contractile reserve provides complementary data to the hemodynamic significance of MS severity, may contribute to clinical decision making, and be of prognostic value in these patients.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Cardiology - Volume 135, Issue 2, 26 June 2009, Pages 193–201
نویسندگان
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