Evaluation of right ventricle pulmonary artery coupling on right ventricular function in post operative tetralogy of Fallot patients underwent for pulmonary valve replacement
Abstract Background To evaluate RV-PA coupling in post operative TOF patients with ventricular dilatation underwent for PVR and investigate the correlation between ventricular functions measuring Ea/Emax ratio using cardio magnetic resonance and the effect of surgical type at primary repair of TOF o...
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doaj-1f70e86ad2c146159959c5b83733627e2020-11-25T01:55:22ZengBMCJournal of Cardiothoracic Surgery1749-80902020-09-011511910.1186/s13019-020-01281-1Evaluation of right ventricle pulmonary artery coupling on right ventricular function in post operative tetralogy of Fallot patients underwent for pulmonary valve replacementBhushan Sandeep0Xin Huang1Yuan Li2Xiaowei Wang3Long Mao4Yue Kan5Dan Xiong6Ke Gao7Xiao Zongwei8Department of Cardiothoracic surgery, Chengdu second People’s HospitalDepartment of Cardiothoracic surgery, Chengdu second People’s HospitalDepartment of Cardiothoracic surgery, Chengdu second People’s HospitalDepartment of Cardiothoracic surgery, Chengdu second People’s HospitalDepartment of Cardiothoracic surgery, Chengdu second People’s HospitalDepartment of Anesthesiology, Chengdu second People’s Hospital ChengduDepartment of Cardiothoracic surgery, Chengdu second People’s HospitalDepartment of Cardiothoracic surgery, Chengdu second People’s HospitalDepartment of Cardiothoracic surgery, Chengdu second People’s HospitalAbstract Background To evaluate RV-PA coupling in post operative TOF patients with ventricular dilatation underwent for PVR and investigate the correlation between ventricular functions measuring Ea/Emax ratio using cardio magnetic resonance and the effect of surgical type at primary repair of TOF on coupling. Method RV-PA coupling was measured noninvasively by Ea/Emax ratio from CMRI and ECHO. From CMRI results the patients were divided in two groups, RV-PA coupling and RV-PA uncoupling. Ea/Emax ≤1 was considered for coupling patients and Ea/Emax > 1 for uncoupling patients. Results Ninety patients were uncoupled (Ea/Emax: 1.55 ± 0.46) and 45 were coupled (Ea/Emax: 0.81 ± 0.15). Out of 75 TAP repaired patients 60 were uncoupled RV-PV. In addition, higher pro-BNP is an important factor for uncoupled RV-PV (P = 0.001). CMR evaluation for right ventricular function between uncoupling and coupling were RVEDVi (196.65 ± 63.57 vs. 154.28 ± 50.07, P = 0.001), RVESVi (121.19 ± 51.47 vs. 83.94 ± 20.43, P = 0.001), RVSVi (67.19 ± 19.87 vs. 106.31 ± 33.44, P = 0.001), and RVEF (40.90 ± 8.73 vs. 54.63 ± 4.76, P = 0.001). The increased RVEDVi, RVESVi and RVSVi and decreased RVEF have significant correlation with Ea/Emax. Ea/Emax was also found positively correlated with RVEDVi (P = < 0.05, r = 0.35), RVESVi (P = < 0.001, r = 0.41) and negatively correlated with RVSVi (P = < 0.05, r = 0.22) and RVEF (P = < 0.05, r = 0.78). Conclusions Unfavorable RV-PA coupling is present in post operative TOF patients and it is affected by several factors. Our results explain a new concept of RV-PA interactions as a contributing mechanism for the observed decline in RV function.http://link.springer.com/article/10.1186/s13019-020-01281-1Right ventricular pulmonary artery (RV-PA)Arterial elastance (Ea)End-systolic elastance (Ees)Cardiac magnetic resonance imaging (CMRI) |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Bhushan Sandeep Xin Huang Yuan Li Xiaowei Wang Long Mao Yue Kan Dan Xiong Ke Gao Xiao Zongwei |
spellingShingle |
Bhushan Sandeep Xin Huang Yuan Li Xiaowei Wang Long Mao Yue Kan Dan Xiong Ke Gao Xiao Zongwei Evaluation of right ventricle pulmonary artery coupling on right ventricular function in post operative tetralogy of Fallot patients underwent for pulmonary valve replacement Journal of Cardiothoracic Surgery Right ventricular pulmonary artery (RV-PA) Arterial elastance (Ea) End-systolic elastance (Ees) Cardiac magnetic resonance imaging (CMRI) |
author_facet |
Bhushan Sandeep Xin Huang Yuan Li Xiaowei Wang Long Mao Yue Kan Dan Xiong Ke Gao Xiao Zongwei |
author_sort |
Bhushan Sandeep |
title |
Evaluation of right ventricle pulmonary artery coupling on right ventricular function in post operative tetralogy of Fallot patients underwent for pulmonary valve replacement |
title_short |
Evaluation of right ventricle pulmonary artery coupling on right ventricular function in post operative tetralogy of Fallot patients underwent for pulmonary valve replacement |
title_full |
Evaluation of right ventricle pulmonary artery coupling on right ventricular function in post operative tetralogy of Fallot patients underwent for pulmonary valve replacement |
title_fullStr |
Evaluation of right ventricle pulmonary artery coupling on right ventricular function in post operative tetralogy of Fallot patients underwent for pulmonary valve replacement |
title_full_unstemmed |
Evaluation of right ventricle pulmonary artery coupling on right ventricular function in post operative tetralogy of Fallot patients underwent for pulmonary valve replacement |
title_sort |
evaluation of right ventricle pulmonary artery coupling on right ventricular function in post operative tetralogy of fallot patients underwent for pulmonary valve replacement |
publisher |
BMC |
series |
Journal of Cardiothoracic Surgery |
issn |
1749-8090 |
publishDate |
2020-09-01 |
description |
Abstract Background To evaluate RV-PA coupling in post operative TOF patients with ventricular dilatation underwent for PVR and investigate the correlation between ventricular functions measuring Ea/Emax ratio using cardio magnetic resonance and the effect of surgical type at primary repair of TOF on coupling. Method RV-PA coupling was measured noninvasively by Ea/Emax ratio from CMRI and ECHO. From CMRI results the patients were divided in two groups, RV-PA coupling and RV-PA uncoupling. Ea/Emax ≤1 was considered for coupling patients and Ea/Emax > 1 for uncoupling patients. Results Ninety patients were uncoupled (Ea/Emax: 1.55 ± 0.46) and 45 were coupled (Ea/Emax: 0.81 ± 0.15). Out of 75 TAP repaired patients 60 were uncoupled RV-PV. In addition, higher pro-BNP is an important factor for uncoupled RV-PV (P = 0.001). CMR evaluation for right ventricular function between uncoupling and coupling were RVEDVi (196.65 ± 63.57 vs. 154.28 ± 50.07, P = 0.001), RVESVi (121.19 ± 51.47 vs. 83.94 ± 20.43, P = 0.001), RVSVi (67.19 ± 19.87 vs. 106.31 ± 33.44, P = 0.001), and RVEF (40.90 ± 8.73 vs. 54.63 ± 4.76, P = 0.001). The increased RVEDVi, RVESVi and RVSVi and decreased RVEF have significant correlation with Ea/Emax. Ea/Emax was also found positively correlated with RVEDVi (P = < 0.05, r = 0.35), RVESVi (P = < 0.001, r = 0.41) and negatively correlated with RVSVi (P = < 0.05, r = 0.22) and RVEF (P = < 0.05, r = 0.78). Conclusions Unfavorable RV-PA coupling is present in post operative TOF patients and it is affected by several factors. Our results explain a new concept of RV-PA interactions as a contributing mechanism for the observed decline in RV function. |
topic |
Right ventricular pulmonary artery (RV-PA) Arterial elastance (Ea) End-systolic elastance (Ees) Cardiac magnetic resonance imaging (CMRI) |
url |
http://link.springer.com/article/10.1186/s13019-020-01281-1 |
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