Stent interventions for pulmonary artery stenosis improve bi-ventricular flow efficiency in a swine model.
J Cardiovasc Magn Reson
; 23(1): 13, 2021 02 25.
Article
in En
| MEDLINE
| ID: mdl-33627121
ABSTRACT
BACKGROUND:
Branch pulmonary artery (PA) stenosis (PAS) commonly occurs in patients with congenital heart disease (CHD). Prior studies have documented technical success and clinical outcomes of PA stent interventions for PAS but the impact of PA stent interventions on ventricular function is unknown. The objective of this study was to utilize 4D flow cardiovascular magnetic resonance (CMR) to better understand the impact of PAS and PA stenting on ventricular contraction and ventricular flow in a swine model of unilateral branch PA stenosis.METHODS:
18 swine (4 sham, 4 untreated left PAS, 10 PAS stent intervention) underwent right heart catheterization and CMR at 20 weeks age (55 kg). CMR included ventricular strain analysis and 4D flow CMR.RESULTS:
4D flow CMR measured inefficient right ventricular (RV) and left ventricular (LV) flow patterns in the PAS group (RV non-dimensional (n.d.) vorticity sham 82 ± 47, PAS 120 ± 47; LV n.d. vorticity sham 57 ± 5, PAS 78 ± 15 p < 0.01) despite the PAS group having normal heart rate, ejection fraction and end-diastolic volume. The intervention group demonstrated increased ejection fraction that resulted in more efficient ventricular flow compared to untreated PAS (RV n.d. vorticity 59 ± 12 p < 0.01; LV n.d. vorticity 41 ± 7 p < 0.001).CONCLUSION:
These results describe previously unknown consequences of PAS on ventricular function in an animal model of unilateral PA stenosis and show that PA stent interventions improve ventricular flow efficiency. This study also highlights the sensitivity of 4D flow CMR biomarkers to detect earlier ventricular dysfunction assisting in identification of patients who may benefit from PAS interventions.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pulmonary Artery
/
Stents
/
Ventricular Function, Left
/
Ventricular Function, Right
/
Ventricular Dysfunction, Right
/
Endovascular Procedures
/
Stenosis, Pulmonary Artery
Limits:
Animals
Language:
En
Journal:
J Cardiovasc Magn Reson
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
/
DIAGNOSTICO POR IMAGEM
Year:
2021
Type:
Article
Affiliation country:
United States