Optimal Heart Rate May Improve Systolic and Diastolic Function in Patients with Fontan Circulation
(1) Background: The optimal heart rate, at which the E-wave and A-wave stand adjacent without any overlaps in the Doppler transmitral flow echocardiography, is associated with maximum cardiac output and favorable clinical outcomes in adult patients with systolic heart failure. However, the clinical...
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| Format: | Article |
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MDPI AG
2023-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/8/3033 |
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| author | Keiichi Hirono Teruhiko Imamura Kaori Tsuboi Shinya Takarada Mako Okabe Hideyuki Nakaoka Keijiro Ibuki Sayaka Ozawa |
| author_facet | Keiichi Hirono Teruhiko Imamura Kaori Tsuboi Shinya Takarada Mako Okabe Hideyuki Nakaoka Keijiro Ibuki Sayaka Ozawa |
| author_sort | Keiichi Hirono |
| collection | DOAJ |
| description | (1) Background: The optimal heart rate, at which the E-wave and A-wave stand adjacent without any overlaps in the Doppler transmitral flow echocardiography, is associated with maximum cardiac output and favorable clinical outcomes in adult patients with systolic heart failure. However, the clinical implication of the echocardiographic overlap length in patients with Fontan circulation remains unknown. We investigated the relationship between heart rate (HR) and hemodynamics in Fontan surgery patients with and without beta-blockers. (2) Methods and Results: A total of 26 patients (median age 1.8 years, 13 males) were enrolled. At baseline, the plasma N-terminal pro-B-type natriuretic peptide was 2439 ± 3483 pg/mL, the fraction area change was 33.5 ± 11.4%, the cardiac index was 3.55 ± 0.90 L/min/m<sup>2</sup>, and the overlap length was 45.2 ± 59.0 msec. Overlap length was importantly decreased after the one-year follow-up (7.60 ± 78.57 msec, <i>p</i> = 0.0069). Positive correlations were noted between the overlap length and A-wave and E/A ratio (<i>p</i> = 0.0021 and <i>p</i> = 0.0046, respectively). Ventricular end-diastolic pressure was significantly correlated with the overlap length in non-beta-blocker patients (<i>p</i> = 0.0483). (3) Conclusion: Overlap length may reflect the status of ventricular dysfunction. Hemodynamic preservation at lower HR could be critical for cardiac reverse remodeling. |
| first_indexed | 2024-03-11T04:52:51Z |
| format | Article |
| id | doaj.art-50e16e3a6a32499eb5c0c9c526c4d897 |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T04:52:51Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-50e16e3a6a32499eb5c0c9c526c4d8972023-11-17T19:52:00ZengMDPI AGJournal of Clinical Medicine2077-03832023-04-01128303310.3390/jcm12083033Optimal Heart Rate May Improve Systolic and Diastolic Function in Patients with Fontan CirculationKeiichi Hirono0Teruhiko Imamura1Kaori Tsuboi2Shinya Takarada3Mako Okabe4Hideyuki Nakaoka5Keijiro Ibuki6Sayaka Ozawa7Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama 930-0194, JapanSecond Internal Medicine, Faculty of Medicine, University of Toyama, Toyama 930-0194, JapanDepartment of Pediatrics, Faculty of Medicine, University of Toyama, Toyama 930-0194, JapanDepartment of Pediatrics, Faculty of Medicine, University of Toyama, Toyama 930-0194, JapanDepartment of Pediatrics, Faculty of Medicine, University of Toyama, Toyama 930-0194, JapanDepartment of Pediatrics, Faculty of Medicine, University of Toyama, Toyama 930-0194, JapanDepartment of Pediatrics, Faculty of Medicine, University of Toyama, Toyama 930-0194, JapanDepartment of Pediatrics, Faculty of Medicine, University of Toyama, Toyama 930-0194, Japan(1) Background: The optimal heart rate, at which the E-wave and A-wave stand adjacent without any overlaps in the Doppler transmitral flow echocardiography, is associated with maximum cardiac output and favorable clinical outcomes in adult patients with systolic heart failure. However, the clinical implication of the echocardiographic overlap length in patients with Fontan circulation remains unknown. We investigated the relationship between heart rate (HR) and hemodynamics in Fontan surgery patients with and without beta-blockers. (2) Methods and Results: A total of 26 patients (median age 1.8 years, 13 males) were enrolled. At baseline, the plasma N-terminal pro-B-type natriuretic peptide was 2439 ± 3483 pg/mL, the fraction area change was 33.5 ± 11.4%, the cardiac index was 3.55 ± 0.90 L/min/m<sup>2</sup>, and the overlap length was 45.2 ± 59.0 msec. Overlap length was importantly decreased after the one-year follow-up (7.60 ± 78.57 msec, <i>p</i> = 0.0069). Positive correlations were noted between the overlap length and A-wave and E/A ratio (<i>p</i> = 0.0021 and <i>p</i> = 0.0046, respectively). Ventricular end-diastolic pressure was significantly correlated with the overlap length in non-beta-blocker patients (<i>p</i> = 0.0483). (3) Conclusion: Overlap length may reflect the status of ventricular dysfunction. Hemodynamic preservation at lower HR could be critical for cardiac reverse remodeling.https://www.mdpi.com/2077-0383/12/8/3033heart rateFontanheart failureoverlap length |
| spellingShingle | Keiichi Hirono Teruhiko Imamura Kaori Tsuboi Shinya Takarada Mako Okabe Hideyuki Nakaoka Keijiro Ibuki Sayaka Ozawa Optimal Heart Rate May Improve Systolic and Diastolic Function in Patients with Fontan Circulation Journal of Clinical Medicine heart rate Fontan heart failure overlap length |
| title | Optimal Heart Rate May Improve Systolic and Diastolic Function in Patients with Fontan Circulation |
| title_full | Optimal Heart Rate May Improve Systolic and Diastolic Function in Patients with Fontan Circulation |
| title_fullStr | Optimal Heart Rate May Improve Systolic and Diastolic Function in Patients with Fontan Circulation |
| title_full_unstemmed | Optimal Heart Rate May Improve Systolic and Diastolic Function in Patients with Fontan Circulation |
| title_short | Optimal Heart Rate May Improve Systolic and Diastolic Function in Patients with Fontan Circulation |
| title_sort | optimal heart rate may improve systolic and diastolic function in patients with fontan circulation |
| topic | heart rate Fontan heart failure overlap length |
| url | https://www.mdpi.com/2077-0383/12/8/3033 |
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