Predictors of right atrial dilatation and long-term function after right ventricular outflow tract surgical repair: Quantification of restrictive physiology matters
Right ventricular (RV) diastolic dysfunction in patients with a surgically-repaired RV outflow tract (RVOT) obstruction merits further studies. Right atrial (RA) dilation and function may be related to (RV) diastolic dysfunction in this setting. The end-diastolic forward flow (EDFF) in the pulmonary...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-03-01
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| Series: | International Journal of Cardiology Congenital Heart Disease |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666668522001185 |
| _version_ | 1811154745158533120 |
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| author | Maria Antonia Pijuan-Domènech Silvia Montserrat Victor Pineda Filipa Valente Ignacio Ferreira-Gonzalez Josep-Ramon Marsal Miguel Angel Castro-Alba Carlos Sureda-Barbosa Berta Miranda-Barrio Maria Teresa Subirana-Domènech Laura Dos-Subirà Jaume Casaldàliga-Ferrer |
| author_facet | Maria Antonia Pijuan-Domènech Silvia Montserrat Victor Pineda Filipa Valente Ignacio Ferreira-Gonzalez Josep-Ramon Marsal Miguel Angel Castro-Alba Carlos Sureda-Barbosa Berta Miranda-Barrio Maria Teresa Subirana-Domènech Laura Dos-Subirà Jaume Casaldàliga-Ferrer |
| author_sort | Maria Antonia Pijuan-Domènech |
| collection | DOAJ |
| description | Right ventricular (RV) diastolic dysfunction in patients with a surgically-repaired RV outflow tract (RVOT) obstruction merits further studies. Right atrial (RA) dilation and function may be related to (RV) diastolic dysfunction in this setting. The end-diastolic forward flow (EDFF) in the pulmonary artery (PA) has been suggested as a non-invasive marker of poor RV compliance, however, there is controversy regarding its true significance; EDFF quantification may help elucidate this controversy. Objective: to study predictors of RA enlargement and dysfunction in patients with a surgically-repaired RVOT obstruction and its relationship with quantitative EDFF. Methods: In 81 consecutive patients (mean age: 37.5 (±7) years), transthoracic echocardiography (Echo) and cardiac magnetic resonance (CMR) were performed. Echo parameters: RA size (indexed RA area (iRAA)), RA function (RA global strain (RAGS)) and maximum EDFF velocity-time integral (VTI-EDFF) obtained during a whole respiratory cycle. CMR-indexed RA area (imRAA) was also obtained. Patients were divided into three groups according to iRAA, imRAA and RAGS; bivariate analysis was performed. A multivariate model was then applied using variables that were found to be statistically significant in the bivariate analysis. Results: Upon multivariate analysis, higher VTI-EDFF values and the presence of significant tricuspid regurgitation proved to be independent factors associated with increased iRAA and imRAA and lower RAGS, whereas RV volumes, function and pulmonary regurgitant fraction were not. Conclusion: VTI-EDFF linearly correlated with the degree of RA dilation and deformation; EDFF quantification as against qualitative assessment may be considered a non-invasive tool for diastolic RV dysfunction. |
| first_indexed | 2024-04-10T04:21:08Z |
| format | Article |
| id | doaj.art-d6acb2d5de794848904ec4ef930ed5a0 |
| institution | Directory Open Access Journal |
| issn | 2666-6685 |
| language | English |
| last_indexed | 2024-04-10T04:21:08Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology Congenital Heart Disease |
| spelling | doaj.art-d6acb2d5de794848904ec4ef930ed5a02023-03-11T04:20:46ZengElsevierInternational Journal of Cardiology Congenital Heart Disease2666-66852023-03-0111100435Predictors of right atrial dilatation and long-term function after right ventricular outflow tract surgical repair: Quantification of restrictive physiology mattersMaria Antonia Pijuan-Domènech0Silvia Montserrat1Victor Pineda2Filipa Valente3Ignacio Ferreira-Gonzalez4Josep-Ramon Marsal5Miguel Angel Castro-Alba6Carlos Sureda-Barbosa7Berta Miranda-Barrio8Maria Teresa Subirana-Domènech9Laura Dos-Subirà10Jaume Casaldàliga-Ferrer11Integrated Adult Congenital Heart Disease Unit, Hospital Vall D′Hebron-Hospital Sant Pau, Passeig Vall D’Hebron 119-129, 08035. Barcelona, Spain; Department of Cardiology, Hospital Universitari Vall D'Hebron, Barcelona, Spain; Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Corresponding author. Adult Congenital Cardiac Unit, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119Barcelona, Spain.Department of Cardiology, Cardiovascular Institute, Hospital Clinic Barcelona, SpainDepartment of Radiology, Hospital Universitari Vall D'Hebron, Barcelona, SpainDepartment of Cardiology, Hospital Universitari Vall D'Hebron, Barcelona, Spain; Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), SpainDepartment of Cardiology, Hospital Universitari Vall D'Hebron, Barcelona, Spain; Centro de Investigación en Red de Epidemiología CIBER-ESP, SpainDepartment of Cardiology, Hospital Universitari Vall D'Hebron, Barcelona, SpainDepartment of Cardiovascular Surgery, Hospital Universitari Vall D'Hebron, Barcelona, SpainDepartment of Cardiovascular Surgery, Hospital Universitari Vall D'Hebron, Barcelona, SpainIntegrated Adult Congenital Heart Disease Unit, Hospital Vall D′Hebron-Hospital Sant Pau, Passeig Vall D’Hebron 119-129, 08035. Barcelona, Spain; Department of Cardiology, Hospital Universitari Vall D'Hebron, Barcelona, Spain; Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), SpainIntegrated Adult Congenital Heart Disease Unit, Hospital Vall D′Hebron-Hospital Sant Pau, Passeig Vall D’Hebron 119-129, 08035. Barcelona, Spain; Department of Cardiology, Hospital Universitari Santa Creu I Sant Pau, Barcelona, SpainIntegrated Adult Congenital Heart Disease Unit, Hospital Vall D′Hebron-Hospital Sant Pau, Passeig Vall D’Hebron 119-129, 08035. Barcelona, Spain; Department of Cardiology, Hospital Universitari Vall D'Hebron, Barcelona, Spain; Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), SpainIntegrated Adult Congenital Heart Disease Unit, Hospital Vall D′Hebron-Hospital Sant Pau, Passeig Vall D’Hebron 119-129, 08035. Barcelona, SpainRight ventricular (RV) diastolic dysfunction in patients with a surgically-repaired RV outflow tract (RVOT) obstruction merits further studies. Right atrial (RA) dilation and function may be related to (RV) diastolic dysfunction in this setting. The end-diastolic forward flow (EDFF) in the pulmonary artery (PA) has been suggested as a non-invasive marker of poor RV compliance, however, there is controversy regarding its true significance; EDFF quantification may help elucidate this controversy. Objective: to study predictors of RA enlargement and dysfunction in patients with a surgically-repaired RVOT obstruction and its relationship with quantitative EDFF. Methods: In 81 consecutive patients (mean age: 37.5 (±7) years), transthoracic echocardiography (Echo) and cardiac magnetic resonance (CMR) were performed. Echo parameters: RA size (indexed RA area (iRAA)), RA function (RA global strain (RAGS)) and maximum EDFF velocity-time integral (VTI-EDFF) obtained during a whole respiratory cycle. CMR-indexed RA area (imRAA) was also obtained. Patients were divided into three groups according to iRAA, imRAA and RAGS; bivariate analysis was performed. A multivariate model was then applied using variables that were found to be statistically significant in the bivariate analysis. Results: Upon multivariate analysis, higher VTI-EDFF values and the presence of significant tricuspid regurgitation proved to be independent factors associated with increased iRAA and imRAA and lower RAGS, whereas RV volumes, function and pulmonary regurgitant fraction were not. Conclusion: VTI-EDFF linearly correlated with the degree of RA dilation and deformation; EDFF quantification as against qualitative assessment may be considered a non-invasive tool for diastolic RV dysfunction.http://www.sciencedirect.com/science/article/pii/S2666668522001185Right diastolic dysfunctionRight ventricular outflow tract surgeryEnd-diastolic: forward flow in pulmonary arteryRight atrium areaRight atrium functionRestrictive physiology |
| spellingShingle | Maria Antonia Pijuan-Domènech Silvia Montserrat Victor Pineda Filipa Valente Ignacio Ferreira-Gonzalez Josep-Ramon Marsal Miguel Angel Castro-Alba Carlos Sureda-Barbosa Berta Miranda-Barrio Maria Teresa Subirana-Domènech Laura Dos-Subirà Jaume Casaldàliga-Ferrer Predictors of right atrial dilatation and long-term function after right ventricular outflow tract surgical repair: Quantification of restrictive physiology matters International Journal of Cardiology Congenital Heart Disease Right diastolic dysfunction Right ventricular outflow tract surgery End-diastolic: forward flow in pulmonary artery Right atrium area Right atrium function Restrictive physiology |
| title | Predictors of right atrial dilatation and long-term function after right ventricular outflow tract surgical repair: Quantification of restrictive physiology matters |
| title_full | Predictors of right atrial dilatation and long-term function after right ventricular outflow tract surgical repair: Quantification of restrictive physiology matters |
| title_fullStr | Predictors of right atrial dilatation and long-term function after right ventricular outflow tract surgical repair: Quantification of restrictive physiology matters |
| title_full_unstemmed | Predictors of right atrial dilatation and long-term function after right ventricular outflow tract surgical repair: Quantification of restrictive physiology matters |
| title_short | Predictors of right atrial dilatation and long-term function after right ventricular outflow tract surgical repair: Quantification of restrictive physiology matters |
| title_sort | predictors of right atrial dilatation and long term function after right ventricular outflow tract surgical repair quantification of restrictive physiology matters |
| topic | Right diastolic dysfunction Right ventricular outflow tract surgery End-diastolic: forward flow in pulmonary artery Right atrium area Right atrium function Restrictive physiology |
| url | http://www.sciencedirect.com/science/article/pii/S2666668522001185 |
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