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Alterations in ventricular pumping in patients with atrial septal defect at rest, during dobutamine stress and after defect closure

Stephensen, Sigurdur S. LU ; Ostenfeld, Ellen LU ; Steding-Ehrenborg, Katarina LU ; Thilén, Ulf LU ; Heiberg, Einar LU ; Arheden, Hakan LU and Carlsson, Marcus LU (2017) In Clinical Physiology and Functional Imaging
Abstract

Background: Regional ventricular pumping mechanisms in patients with volume-loaded right ventricles (RV) are altered, but the cause is unknown. The aim was to determine whether these changes in ventricular pumping mechanisms are influenced by the RV dilatation itself or the aetiology behind it. Methods: Seventeen patients with atrial septal defects (ASD) and 10 healthy controls underwent cardiovascular magnetic resonance (CMR) at rest and during dobutamine/atropine stress. Sixteen patients underwent transcutaneous ASD closure. Follow-up CMR at rest was performed the following day. Thirty patients with RV overload due to pulmonary regurgitation (PR) underwent CMR at rest. Cine images were used to measure left ventricular (LV) and RV... (More)

Background: Regional ventricular pumping mechanisms in patients with volume-loaded right ventricles (RV) are altered, but the cause is unknown. The aim was to determine whether these changes in ventricular pumping mechanisms are influenced by the RV dilatation itself or the aetiology behind it. Methods: Seventeen patients with atrial septal defects (ASD) and 10 healthy controls underwent cardiovascular magnetic resonance (CMR) at rest and during dobutamine/atropine stress. Sixteen patients underwent transcutaneous ASD closure. Follow-up CMR at rest was performed the following day. Thirty patients with RV overload due to pulmonary regurgitation (PR) underwent CMR at rest. Cine images were used to measure left ventricular (LV) and RV volumes as well as septal, longitudinal and lateral contributions to LV and RV stroke volume (SV). Results: At rest, septal contribution to LVSV was lower in ASD patients than controls (-1% versus 7%, P<0·05), but there was no difference in longitudinal or lateral contribution to SV. Patients with PR had lower longitudinal contribution to RV with increased lateral and septal contribution. During dobutamine stress, longitudinal contribution to LV and RVSV decreased and lateral contribution increased for ASD patients and controls. The day after ASD closure, septal contribution to LVSV was 6%, longitudinal contribution had increased for RVSV (P<0·05) and decreased for LVSV (P<0·01). Conclusion: Pumping mechanisms in patients with RV volume overload depend on the aetiology for the RV dilation and not the size of the RV.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Atrial septal defect, Congenital heart defects, Longitudinal pumping, Radial pumping, Right ventricular volume load, Tetralogy of Fallot
in
Clinical Physiology and Functional Imaging
publisher
Wiley Online Library
external identifiers
  • scopus:85037988872
ISSN
1475-0961
DOI
10.1111/cpf.12491
language
English
LU publication?
yes
id
45281586-ea0d-4526-826a-cda00fca9c53
date added to LUP
2018-01-10 15:12:34
date last changed
2018-01-11 03:00:03
@article{45281586-ea0d-4526-826a-cda00fca9c53,
  abstract     = {<p>Background: Regional ventricular pumping mechanisms in patients with volume-loaded right ventricles (RV) are altered, but the cause is unknown. The aim was to determine whether these changes in ventricular pumping mechanisms are influenced by the RV dilatation itself or the aetiology behind it. Methods: Seventeen patients with atrial septal defects (ASD) and 10 healthy controls underwent cardiovascular magnetic resonance (CMR) at rest and during dobutamine/atropine stress. Sixteen patients underwent transcutaneous ASD closure. Follow-up CMR at rest was performed the following day. Thirty patients with RV overload due to pulmonary regurgitation (PR) underwent CMR at rest. Cine images were used to measure left ventricular (LV) and RV volumes as well as septal, longitudinal and lateral contributions to LV and RV stroke volume (SV). Results: At rest, septal contribution to LVSV was lower in ASD patients than controls (-1% versus 7%, P&lt;0·05), but there was no difference in longitudinal or lateral contribution to SV. Patients with PR had lower longitudinal contribution to RV with increased lateral and septal contribution. During dobutamine stress, longitudinal contribution to LV and RVSV decreased and lateral contribution increased for ASD patients and controls. The day after ASD closure, septal contribution to LVSV was 6%, longitudinal contribution had increased for RVSV (P&lt;0·05) and decreased for LVSV (P&lt;0·01). Conclusion: Pumping mechanisms in patients with RV volume overload depend on the aetiology for the RV dilation and not the size of the RV.</p>},
  author       = {Stephensen, Sigurdur S. and Ostenfeld, Ellen and Steding-Ehrenborg, Katarina and Thilén, Ulf and Heiberg, Einar and Arheden, Hakan and Carlsson, Marcus},
  issn         = {1475-0961},
  keyword      = {Atrial septal defect,Congenital heart defects,Longitudinal pumping,Radial pumping,Right ventricular volume load,Tetralogy of Fallot},
  language     = {eng},
  publisher    = {Wiley Online Library},
  series       = {Clinical Physiology and Functional Imaging},
  title        = {Alterations in ventricular pumping in patients with atrial septal defect at rest, during dobutamine stress and after defect closure},
  url          = {http://dx.doi.org/10.1111/cpf.12491},
  year         = {2017},
}