The impact of unilateral pulmonary artery stenosis on right ventricular to pulmonary arterial coupling in patients with transposition of the great arteries.
Catheter Cardiovasc Interv
; 103(6): 943-948, 2024 May.
Article
en En
| MEDLINE
| ID: mdl-38577955
ABSTRACT
BACKGROUND:
Unilateral pulmonary artery (PA) stenosis is common in the transposition of the great arteries (TGA) after arterial switch operation (ASO) but the effects on the right ventricle (RV) remain unclear.AIMS:
To assess the effects of unilateral PA stenosis on RV afterload and function in pediatric patients with TGA-ASO.METHODS:
In this retrospective study, eight TGA patients with unilateral PA stenosis underwent heart catheterization and cardiac magnetic resonance (CMR) imaging. RV pressures, RV afterload (arterial elastance [Ea]), PA compliance, RV contractility (end-systolic elastance [Ees]), RV-to-PA (RV-PA) coupling (Ees/Ea), and RV diastolic stiffness (end-diastolic elastance [Eed]) were analyzed and compared to normal values from the literature.RESULTS:
In all TGA patients (mean age 12 ± 3 years), RV afterload (Ea) and RV pressures were increased whereas PA compliance was reduced. RV contractility (Ees) was decreased resulting in RV-PA uncoupling. RV diastolic stiffness (Eed) was increased. CMR-derived RV volumes, mass, and ejection fraction were preserved.CONCLUSION:
Unilateral PA stenosis results in an increased RV afterload in TGA patients after ASO. RV remodeling and function remain within normal limits when analyzed by CMR but RV pressure-volume loop analysis shows impaired RV diastolic stiffness and RV contractility leading to RV-PA uncoupling.Palabras clave
Texto completo:
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Base de datos:
MEDLINE
Asunto principal:
Arteria Pulmonar
/
Transposición de los Grandes Vasos
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Cateterismo Cardíaco
/
Función Ventricular Derecha
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Operación de Switch Arterial
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Estenosis de Arteria Pulmonar
Idioma:
En
Revista:
Catheter Cardiovasc Interv
Asunto de la revista:
CARDIOLOGIA
Año:
2024
Tipo del documento:
Article