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Isolated pulmonary regurgitation causes decreased right ventricular longitudinal function and compensatory increased septal pumping in a porcine model

Kopic, S. LU ; Stephensen, S. S. LU ; Heiberg, E. LU ; Arheden, H. LU ; Bonhoeffer, P.; Ersbøll, M.; Vejlstrup, Niels; Søndergaard, L and Carlsson, M. LU (2017) In Acta Physiologica2006-01-01+01:002013-01-01+01:00 221(3). p.163-173
Abstract

Aim: Longitudinal ventricular contraction is a parameter of cardiac performance with predictive power. Right ventricular (RV) longitudinal function is impaired in patients with free pulmonary regurgitation (PR) following corrective surgery for Tetralogy of Fallot (TOF). It remains unclear whether this is a consequence of the surgical repair, or whether it is inherent to PR. The aim of this study was to assess the relationship between longitudinal, lateral and septal pumping in a porcine model of isolated PR. Methods: Piglets were divided into a control (n = 8) group and a treatment (n = 12) group, which received a stent in the pulmonary valve orifice, inducing PR. After 2-3 months, animals were subjected to cardiac magnetic resonance... (More)

Aim: Longitudinal ventricular contraction is a parameter of cardiac performance with predictive power. Right ventricular (RV) longitudinal function is impaired in patients with free pulmonary regurgitation (PR) following corrective surgery for Tetralogy of Fallot (TOF). It remains unclear whether this is a consequence of the surgical repair, or whether it is inherent to PR. The aim of this study was to assess the relationship between longitudinal, lateral and septal pumping in a porcine model of isolated PR. Methods: Piglets were divided into a control (n = 8) group and a treatment (n = 12) group, which received a stent in the pulmonary valve orifice, inducing PR. After 2-3 months, animals were subjected to cardiac magnetic resonance imaging. A subset of animals (n = 6) then underwent percutaneous pulmonary valve replacement (PPVR) with follow-up 1 month later. Longitudinal, lateral and septal contributions to stroke volume (SV) were quantified by measuring volumetric displacements from end-diastole to end-systole in the cardiac short axis and long axis. Results: PR resulted in a lower longitudinal contribution to RV stroke volume, compared to controls (60.0 ± 2.6% vs. 73.6 ± 3.8%; P = 0.012). Furthermore, a compensatory increase in septal contribution to RVSV was observed (11.0 ± 1.6% vs. -3.1 ± 1.5%; P < 0.0001). The left ventricle (LV) showed counter-regulation with an increased longitudinal LVSV. Changes in RV longitudinal function were reversed by PPVR. Conclusion: These findings suggest that PR contributes to decreased RV longitudinal function in the absence of scarring from cardiac surgery. Measurement of longitudinal RVSV may aid risk stratification and timing for interventional correction of PR in TOF patients.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiac magnetic resonance, Mitral annular plane systolic excursion (MAPSE), Tetralogy of Fallot, Tricuspid annular plane systolic excursion, Ventricular function
in
Acta Physiologica2006-01-01+01:002013-01-01+01:00
volume
221
issue
3
pages
163 - 173
publisher
Wiley-Blackwell
external identifiers
  • scopus:85021408421
  • wos:000412935500005
ISSN
1748-1708
DOI
10.1111/apha.12904
language
English
LU publication?
yes
id
d55d9380-e415-4c8e-b904-e7e4a6cc2d62
date added to LUP
2017-07-12 14:18:53
date last changed
2018-01-16 13:21:12
@article{d55d9380-e415-4c8e-b904-e7e4a6cc2d62,
  abstract     = {<p>Aim: Longitudinal ventricular contraction is a parameter of cardiac performance with predictive power. Right ventricular (RV) longitudinal function is impaired in patients with free pulmonary regurgitation (PR) following corrective surgery for Tetralogy of Fallot (TOF). It remains unclear whether this is a consequence of the surgical repair, or whether it is inherent to PR. The aim of this study was to assess the relationship between longitudinal, lateral and septal pumping in a porcine model of isolated PR. Methods: Piglets were divided into a control (n = 8) group and a treatment (n = 12) group, which received a stent in the pulmonary valve orifice, inducing PR. After 2-3 months, animals were subjected to cardiac magnetic resonance imaging. A subset of animals (n = 6) then underwent percutaneous pulmonary valve replacement (PPVR) with follow-up 1 month later. Longitudinal, lateral and septal contributions to stroke volume (SV) were quantified by measuring volumetric displacements from end-diastole to end-systole in the cardiac short axis and long axis. Results: PR resulted in a lower longitudinal contribution to RV stroke volume, compared to controls (60.0 ± 2.6% vs. 73.6 ± 3.8%; P = 0.012). Furthermore, a compensatory increase in septal contribution to RVSV was observed (11.0 ± 1.6% vs. -3.1 ± 1.5%; P &lt; 0.0001). The left ventricle (LV) showed counter-regulation with an increased longitudinal LVSV. Changes in RV longitudinal function were reversed by PPVR. Conclusion: These findings suggest that PR contributes to decreased RV longitudinal function in the absence of scarring from cardiac surgery. Measurement of longitudinal RVSV may aid risk stratification and timing for interventional correction of PR in TOF patients.</p>},
  author       = {Kopic, S. and Stephensen, S. S. and Heiberg, E. and Arheden, H. and Bonhoeffer, P. and Ersbøll, M. and Vejlstrup, Niels and Søndergaard, L and Carlsson, M.},
  issn         = {1748-1708},
  keyword      = {Cardiac magnetic resonance,Mitral annular plane systolic excursion (MAPSE),Tetralogy of Fallot,Tricuspid annular plane systolic excursion,Ventricular function},
  language     = {eng},
  month        = {06},
  number       = {3},
  pages        = {163--173},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Physiologica2006-01-01+01:002013-01-01+01:00},
  title        = {Isolated pulmonary regurgitation causes decreased right ventricular longitudinal function and compensatory increased septal pumping in a porcine model},
  url          = {http://dx.doi.org/10.1111/apha.12904},
  volume       = {221},
  year         = {2017},
}