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Right ventricular restrictive physiology in repaired tetralogy of Fallot is associated with smaller respiratory variability.

Authors
 Jae Young Choi  ;  Hae Sik Kwon  ;  Byung Won Yoo  ;  Jae Il Shin  ;  Jun Hee Sul  ;  Han Ki Park  ;  Young Hwan Park 
Citation
 INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol.125(1) : 28-35, 2008 
Journal Title
 INTERNATIONAL JOURNAL OF CARDIOLOGY 
ISSN
 0167-5273 
Issue Date
2008
MeSH
Adolescent ; Cardiac Surgical Procedures/adverse effects* ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Prospective Studies ; Respiratory Function Tests ; Respiratory Tract Diseases/etiology* ; Respiratory Tract Diseases/physiopathology ; Tetralogy of Fallot/complications ; Tetralogy of Fallot/physiopathology ; Tetralogy of Fallot/surgery* ; Time Factors ; Ultrasonography ; Ventricular Dysfunction, Right/diagnostic imaging ; Ventricular Dysfunction, Right/etiology* ; Ventricular Dysfunction, Right/physiopathology*
Keywords
Tetralogy of Fallot ; Circulatory and respiratory physiology ; Doppler echocardiography ; Ventricular function
Abstract
BACKGROUND: Long-term outcomes of patients with repaired tetralogy of Fallot (TOF) are known to be related with right ventricular (RV) volume overload, severity of pulmonary insufficiency (PI) and the type of outflow repair. Right ventricular restrictive physiology (RVRP) has also been reported to interfere with several factors influencing the late result in repaired TOF patients. However, the mechanism and physiology of this unique myocardial property in the chronically overloaded right ventricle are not yet clearly understood. METHODS: We investigated 43 patients after repair of TOF to assess the relationships among biventricular diastolic function, volume characteristics, and influence of respiratory effort. The patients were classified into 3 groups; 15 patients with RVRP and significant PI (RP group, 35%), 19 without RVRP in the presence of significant PI (NR+PI group, 44%), and 9 without RP or significant PI (NR-PI group, 21%). Doppler spectrals obtained by echocardiography from systemic and pulmonary veins, main pulmonary artery (MPA), and both ventricular inlets, and biventricular diastolic function were compared according to the respiratory cycle. RESULTS: The RP group revealed higher pulmonary venous systolic/diastolic flow ratio (S/D ratio) and the NR+PI group showed larger velocity-time integral (VTI) ratio of total regurgitant/antegrade flow at the MPA and more respiratory variability in the systemic vein. CONCLUSION: RP is associated with less volume overload of the RV and smaller respiratory variability is also associated with the restrictive RV. The diastolic function and volume status of the RV may influence the diastolic properties of the left heart
Full Text
http://www.sciencedirect.com/science/article/pii/S0167527307004913
DOI
10.1016/j.ijcard.2007.02.020
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Yoo, Byung Won(류병원) ORCID logo https://orcid.org/0000-0001-6895-1484
Park, Young Hwan(박영환)
Park, Han Ki(박한기) ORCID logo https://orcid.org/0000-0002-7472-7822
Sul, Jun Hui(설준희)
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
Choi, Jae Young(최재영) ORCID logo https://orcid.org/0000-0002-1247-6669
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107429
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