کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5975258 | 1576216 | 2013 | 5 صفحه PDF | دانلود رایگان |
BackgroundThe intervention timing in atrial septal defect (ASD) or pulmonary valvular stenosis (PVS) is more dependent on symptoms than right ventricular (RV) damage in clinical practice. RV long-axis function is sensitive in revealing RV myocardial dysfunction. We evaluate the impact of different chronic loading conditions on RV long-axis function and its relationship to patients' symptoms in ASD or PVS.MethodsTransthoracic echocardiography was performed in normals (n = 39) and patients with isolated secundum ASD (n = 45) or PVS (n = 38). RV volume- and pressure-overloading were defined as the ratio of RV/left ventricular end-diastolic dimension â¥Â 0.5 and RV systolic pressure â¥Â 40 mm Hg, respectively. RV long-axis dysfunction was defined as M-mode tricuspid annular plane systolic excursion (TAPSE) < 1.6 cm. New York Heart Association (NYHA) functional class and other symptoms (decreased exercise tolerance, palpitation and chest pain) were recorded.ResultsThirty-nine (32.0%) had normal loading (Group 1; 39 normals); 24 (19.6%) had isolated volume-overloading (Group 2; all ASDs); 21 (17.2%) had isolated pressure-overloading (Group 3; 21 PVSs) and 38 (31.1%) had both overloading conditions (Group 4; 21 ASDs and 17 PVSs). RV long-axis dysfunction in abnormal loading groups were zero (0%, Group 2), 21 (100%, Group 3) and 22 (57.8%, Group 4) (Ï2 = 45.9, p < 0.001). Group 3 were more symptomatic (NYHA functional class 2.5 ± 0.6 versus 1.6 ± 0.5, p < 0.05) and had lower TAPSE (1.6 ± 0.4 versus 3.0 ± 0.7 cm, p < 0.05) than Group 2. RV long-axis dysfunction was the strongest predictor of the presence of symptoms (odds ratio = 9.298, p < 0.001).ConclusionChronic volume-overloading accentuates while pressure-overloading attenuates RV long-axis excursion and its impairment was associated with the presence of symptoms.
Journal: International Journal of Cardiology - Volume 167, Issue 2, 31 July 2013, Pages 378-382