Assessment of left ventricular dyssynchrony and function using real-time 3-dimensional echocardiography in patients with congenital right heart disease
Background Patients after repair of congenital right heart disease (CRHD) may exhibit left ventricular (LV) dyssynchrony (LVD). However, the diagnosis of LVD is difficult and its reliability limited because current methods do not assess LVD of the whole LV simultaneously. The aim of the study was to...
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| Veröffentlicht in: | The American heart journal 2009-04, Vol.157 (4), p.791-798 |
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| creator | Raedle-Hurst, Tanja M., MD Mueller, Matthias Rentzsch, Axel, MD Schaefers, Hans-Joachim, MD Herrmann, Eva, PhD Abdul-Khaliq, Hashim, MD |
| description | Background Patients after repair of congenital right heart disease (CRHD) may exhibit left ventricular (LV) dyssynchrony (LVD). However, the diagnosis of LVD is difficult and its reliability limited because current methods do not assess LVD of the whole LV simultaneously. The aim of the study was to assess LVD according to a novel global systolic dyssynchrony index (SDI) derived from real-time 3-dimensional echocardiography in patients after repaired CRHD. Methods Two-dimensional echocardiography and real-time 3-dimensional echocardiography were performed in 30 patients after CRHD repair and in 30 matched healthy controls. Real-time 3-dimensional echocardiography data sets provided time-volume curves, and 2 global SDIs were derived from the dispersion of time to reach minimal systolic volume according to a 16- or 17-LV segment model. Results Both SDIs were significantly elevated in the patient as compared with the control group ( P < .001). A cutoff value for both SDIs was calculated and LVD defined as one of the SDIs exceeding cutoff. Left ventricular dyssynchrony was present in 5 (100%) of 5 patients with a LV ejection fraction (EF) |
| doi_str_mv | 10.1016/j.ahj.2008.12.015 |
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However, the diagnosis of LVD is difficult and its reliability limited because current methods do not assess LVD of the whole LV simultaneously. The aim of the study was to assess LVD according to a novel global systolic dyssynchrony index (SDI) derived from real-time 3-dimensional echocardiography in patients after repaired CRHD. Methods Two-dimensional echocardiography and real-time 3-dimensional echocardiography were performed in 30 patients after CRHD repair and in 30 matched healthy controls. Real-time 3-dimensional echocardiography data sets provided time-volume curves, and 2 global SDIs were derived from the dispersion of time to reach minimal systolic volume according to a 16- or 17-LV segment model. Results Both SDIs were significantly elevated in the patient as compared with the control group ( P < .001). A cutoff value for both SDIs was calculated and LVD defined as one of the SDIs exceeding cutoff. Left ventricular dyssynchrony was present in 5 (100%) of 5 patients with a LV ejection fraction (EF) <50% and 13 (52%) of 25 patients with preserved LVEF, thus being diagnosed in a total of 18 (60%) of 30 patients. Moreover, patients with LVD showed a significantly higher degree of pulmonary regurgitation ( P = .01) with elevated right ventricular volumes and altered septal motion. Stepwise multivariate analysis identified LVEF ( P = .005) and the degree of pulmonary regurgitation ( P = .02) as independent predictors of LVD. Conclusions Left ventricular dyssynchrony can be detected in about 60% of patients after CRHD repair and is mainly due to significant pulmonary regurgitation resulting in an altered septal motion and systolic LV function.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2008.12.015</identifier><identifier>PMID: 19332212</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Acquisitions & mergers ; Adolescent ; Adult ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Cardiovascular system ; Child ; Echocardiography, Three-Dimensional - methods ; Female ; Follow-Up Studies ; Heart attacks ; Heart Defects, Congenital - complications ; Heart Defects, Congenital - diagnostic imaging ; Heart Defects, Congenital - physiopathology ; Heart failure ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Methods ; Multivariate analysis ; Reproducibility of Results ; Risk Factors ; Stroke Volume - physiology ; Time Factors ; Ultrasonic investigative techniques ; Ventricular Dysfunction, Left - diagnostic imaging ; Ventricular Dysfunction, Left - etiology ; Ventricular Dysfunction, Left - physiopathology ; Ventricular Function, Left - physiology ; Young Adult</subject><ispartof>The American heart journal, 2009-04, Vol.157 (4), p.791-798</ispartof><rights>Mosby, Inc.</rights><rights>2009 Mosby, Inc.</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Elsevier Limited Apr 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-8352e5fbf6cf16ff6b66f7b9e239503834de6bbcb4009fb881b14305150309193</citedby><cites>FETCH-LOGICAL-c464t-8352e5fbf6cf16ff6b66f7b9e239503834de6bbcb4009fb881b14305150309193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1504590823?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21416215$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19332212$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Raedle-Hurst, Tanja M., MD</creatorcontrib><creatorcontrib>Mueller, Matthias</creatorcontrib><creatorcontrib>Rentzsch, Axel, MD</creatorcontrib><creatorcontrib>Schaefers, Hans-Joachim, MD</creatorcontrib><creatorcontrib>Herrmann, Eva, PhD</creatorcontrib><creatorcontrib>Abdul-Khaliq, Hashim, MD</creatorcontrib><title>Assessment of left ventricular dyssynchrony and function using real-time 3-dimensional echocardiography in patients with congenital right heart disease</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background Patients after repair of congenital right heart disease (CRHD) may exhibit left ventricular (LV) dyssynchrony (LVD). However, the diagnosis of LVD is difficult and its reliability limited because current methods do not assess LVD of the whole LV simultaneously. The aim of the study was to assess LVD according to a novel global systolic dyssynchrony index (SDI) derived from real-time 3-dimensional echocardiography in patients after repaired CRHD. Methods Two-dimensional echocardiography and real-time 3-dimensional echocardiography were performed in 30 patients after CRHD repair and in 30 matched healthy controls. Real-time 3-dimensional echocardiography data sets provided time-volume curves, and 2 global SDIs were derived from the dispersion of time to reach minimal systolic volume according to a 16- or 17-LV segment model. Results Both SDIs were significantly elevated in the patient as compared with the control group ( P < .001). A cutoff value for both SDIs was calculated and LVD defined as one of the SDIs exceeding cutoff. Left ventricular dyssynchrony was present in 5 (100%) of 5 patients with a LV ejection fraction (EF) <50% and 13 (52%) of 25 patients with preserved LVEF, thus being diagnosed in a total of 18 (60%) of 30 patients. Moreover, patients with LVD showed a significantly higher degree of pulmonary regurgitation ( P = .01) with elevated right ventricular volumes and altered septal motion. Stepwise multivariate analysis identified LVEF ( P = .005) and the degree of pulmonary regurgitation ( P = .02) as independent predictors of LVD. Conclusions Left ventricular dyssynchrony can be detected in about 60% of patients after CRHD repair and is mainly due to significant pulmonary regurgitation resulting in an altered septal motion and systolic LV function.</description><subject>Acquisitions & mergers</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular system</subject><subject>Child</subject><subject>Echocardiography, Three-Dimensional - methods</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart attacks</subject><subject>Heart Defects, Congenital - complications</subject><subject>Heart Defects, Congenital - diagnostic imaging</subject><subject>Heart Defects, Congenital - physiopathology</subject><subject>Heart failure</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methods</subject><subject>Multivariate analysis</subject><subject>Reproducibility of Results</subject><subject>Risk Factors</subject><subject>Stroke Volume - physiology</subject><subject>Time Factors</subject><subject>Ultrasonic investigative techniques</subject><subject>Ventricular Dysfunction, Left - diagnostic imaging</subject><subject>Ventricular Dysfunction, Left - etiology</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><subject>Ventricular Function, Left - physiology</subject><subject>Young Adult</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9ks-KFDEQxhtR3HH1AbxIQPTWYyXdnelGEJbFf7DgQT2HdLoynbEnGVPplX4SX9eMM7iwB0-hqF99qaqviuI5hzUHLt_s1nrcrQVAu-ZiDbx5UKw4dJtSbur6YbECAFG2G6guiidEuxxK0crHxQXvqkoILlbF7ysiJNqjTyxYNqFN7DYH0Zl50pENC9HizRiDX5j2A7OzN8kFz2Zyfssi6qlMbo-sKof8eMo5PTE0YzA6Di5soz6MC3OeHXRyWZrYL5dGZoLfoncpw9Ftx8RG1DGxwRFqwqfFI6snwmfn97L4_uH9t-tP5c2Xj5-vr25KU8s6lW3VCGxsb6WxXForeyntpu9QVF0DVVvVA8q-N30N0Nm-bXnP6woanpPQ5TVcFq9PuocYfs5ISe0dGZwm7THMpOQGWsm5yODLe-AuzDGPSiqL1U0HragyxU-UiYEoolWH6PY6LoqDOnqmdip7po6eKS5U9izXvDgrz_0eh7uKs0kZeHUGNBk92ai9cfSPE7zmUvwVenviMC_s1mFUZPLCDQ4uoklqCO6_bby7V20m513-8AcuSHfTKsoF6uvxuI63BS1wkLnNP7vmyyU</recordid><startdate>20090401</startdate><enddate>20090401</enddate><creator>Raedle-Hurst, Tanja M., MD</creator><creator>Mueller, Matthias</creator><creator>Rentzsch, Axel, MD</creator><creator>Schaefers, Hans-Joachim, MD</creator><creator>Herrmann, Eva, PhD</creator><creator>Abdul-Khaliq, Hashim, MD</creator><general>Mosby, Inc</general><general>Mosby</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20090401</creationdate><title>Assessment of left ventricular dyssynchrony and function using real-time 3-dimensional echocardiography in patients with congenital right heart disease</title><author>Raedle-Hurst, Tanja M., MD ; Mueller, Matthias ; Rentzsch, Axel, MD ; Schaefers, Hans-Joachim, MD ; Herrmann, Eva, PhD ; Abdul-Khaliq, Hashim, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-8352e5fbf6cf16ff6b66f7b9e239503834de6bbcb4009fb881b14305150309193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Acquisitions & mergers</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>Cardiology. 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physiopathology</topic><topic>Ventricular Function, Left - physiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Raedle-Hurst, Tanja M., MD</creatorcontrib><creatorcontrib>Mueller, Matthias</creatorcontrib><creatorcontrib>Rentzsch, Axel, MD</creatorcontrib><creatorcontrib>Schaefers, Hans-Joachim, MD</creatorcontrib><creatorcontrib>Herrmann, Eva, PhD</creatorcontrib><creatorcontrib>Abdul-Khaliq, Hashim, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Raedle-Hurst, Tanja M., MD</au><au>Mueller, Matthias</au><au>Rentzsch, Axel, MD</au><au>Schaefers, Hans-Joachim, MD</au><au>Herrmann, Eva, PhD</au><au>Abdul-Khaliq, Hashim, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of left ventricular dyssynchrony and function using real-time 3-dimensional echocardiography in patients with congenital right heart disease</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2009-04-01</date><risdate>2009</risdate><volume>157</volume><issue>4</issue><spage>791</spage><epage>798</epage><pages>791-798</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background Patients after repair of congenital right heart disease (CRHD) may exhibit left ventricular (LV) dyssynchrony (LVD). However, the diagnosis of LVD is difficult and its reliability limited because current methods do not assess LVD of the whole LV simultaneously. The aim of the study was to assess LVD according to a novel global systolic dyssynchrony index (SDI) derived from real-time 3-dimensional echocardiography in patients after repaired CRHD. Methods Two-dimensional echocardiography and real-time 3-dimensional echocardiography were performed in 30 patients after CRHD repair and in 30 matched healthy controls. Real-time 3-dimensional echocardiography data sets provided time-volume curves, and 2 global SDIs were derived from the dispersion of time to reach minimal systolic volume according to a 16- or 17-LV segment model. Results Both SDIs were significantly elevated in the patient as compared with the control group ( P < .001). A cutoff value for both SDIs was calculated and LVD defined as one of the SDIs exceeding cutoff. Left ventricular dyssynchrony was present in 5 (100%) of 5 patients with a LV ejection fraction (EF) <50% and 13 (52%) of 25 patients with preserved LVEF, thus being diagnosed in a total of 18 (60%) of 30 patients. Moreover, patients with LVD showed a significantly higher degree of pulmonary regurgitation ( P = .01) with elevated right ventricular volumes and altered septal motion. Stepwise multivariate analysis identified LVEF ( P = .005) and the degree of pulmonary regurgitation ( P = .02) as independent predictors of LVD. Conclusions Left ventricular dyssynchrony can be detected in about 60% of patients after CRHD repair and is mainly due to significant pulmonary regurgitation resulting in an altered septal motion and systolic LV function.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>19332212</pmid><doi>10.1016/j.ahj.2008.12.015</doi><tpages>8</tpages></addata></record> |
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| subjects | Acquisitions & mergers Adolescent Adult Biological and medical sciences Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular disease Cardiovascular system Child Echocardiography, Three-Dimensional - methods Female Follow-Up Studies Heart attacks Heart Defects, Congenital - complications Heart Defects, Congenital - diagnostic imaging Heart Defects, Congenital - physiopathology Heart failure Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Methods Multivariate analysis Reproducibility of Results Risk Factors Stroke Volume - physiology Time Factors Ultrasonic investigative techniques Ventricular Dysfunction, Left - diagnostic imaging Ventricular Dysfunction, Left - etiology Ventricular Dysfunction, Left - physiopathology Ventricular Function, Left - physiology Young Adult |
| title | Assessment of left ventricular dyssynchrony and function using real-time 3-dimensional echocardiography in patients with congenital right heart disease |
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