Age at death in the hypoplastic left heart syndrome: Multivariate analysis and importance of the coronary arteries
Survival analysis of 63 fatal cases of the hypoplastic left heart syndrome was undertaken to determine whether morphologic measurements related to coronary blood flow would predict the length of postnatal survival. Cross-sectional areas of the ascending aorta and proximal left and right coronary art...
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| Veröffentlicht in: | The American heart journal 1989-06, Vol.117 (6), p.1337-1343 |
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| container_title | The American heart journal |
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| creator | Lloyd, Thomas R. Marvin, William J. |
| description | Survival analysis of 63 fatal cases of the hypoplastic left heart syndrome was undertaken to determine whether morphologic measurements related to coronary blood flow would predict the length of postnatal survival. Cross-sectional areas of the ascending aorta and proximal left and right coronary arteries, left and right ventricular mass, coronary artery dominance pattern, and the presence of discrete coarctation were determined from autopsy specimens. These values were used to construct survival functions using Cox regression. Survival was significantly prolonged in cases with larger cross-sectional areas of the left (
p < 0.005) and right (
p < 0.05) coronary arteries, right ventricular mass (
p < 0.005), and combined ventricular mass (
p < 0.005). A multivariate model was developed that included combined left and right coronary artery cross-sectional areas, right ventricular mass, and the ratio of combined coronary artery area-to-combined ventricular mass. This model also significantly (
p < 0.001) predicted instantaneous risk of death, and again larger covariate values were associated with longer survival. These results suggest that myocardial perfusion is an important determinant of survival in these infants. |
| doi_str_mv | 10.1016/0002-8703(89)90416-X |
| format | Article |
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p < 0.005) and right (
p < 0.05) coronary arteries, right ventricular mass (
p < 0.005), and combined ventricular mass (
p < 0.005). A multivariate model was developed that included combined left and right coronary artery cross-sectional areas, right ventricular mass, and the ratio of combined coronary artery area-to-combined ventricular mass. This model also significantly (
p < 0.001) predicted instantaneous risk of death, and again larger covariate values were associated with longer survival. These results suggest that myocardial perfusion is an important determinant of survival in these infants.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/0002-8703(89)90416-X</identifier><identifier>PMID: 2729061</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Age Factors ; Aorta - pathology ; Biological and medical sciences ; Cardiology. Vascular system ; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava ; Coronary Vessels - pathology ; Heart ; Heart Defects, Congenital - mortality ; Heart Defects, Congenital - pathology ; Humans ; Infant ; Infant, Newborn ; Medical sciences ; Myocardium - pathology ; Retrospective Studies ; Syndrome</subject><ispartof>The American heart journal, 1989-06, Vol.117 (6), p.1337-1343</ispartof><rights>1989</rights><rights>1989 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c386t-d5e8237c25600f099f4e8823f31ffc63b99f10e20b8a94d4604186d75d08a4363</citedby><cites>FETCH-LOGICAL-c386t-d5e8237c25600f099f4e8823f31ffc63b99f10e20b8a94d4604186d75d08a4363</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0002-8703(89)90416-X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27925,27926,45996</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=7253492$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2729061$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lloyd, Thomas R.</creatorcontrib><creatorcontrib>Marvin, William J.</creatorcontrib><title>Age at death in the hypoplastic left heart syndrome: Multivariate analysis and importance of the coronary arteries</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Survival analysis of 63 fatal cases of the hypoplastic left heart syndrome was undertaken to determine whether morphologic measurements related to coronary blood flow would predict the length of postnatal survival. Cross-sectional areas of the ascending aorta and proximal left and right coronary arteries, left and right ventricular mass, coronary artery dominance pattern, and the presence of discrete coarctation were determined from autopsy specimens. These values were used to construct survival functions using Cox regression. Survival was significantly prolonged in cases with larger cross-sectional areas of the left (
p < 0.005) and right (
p < 0.05) coronary arteries, right ventricular mass (
p < 0.005), and combined ventricular mass (
p < 0.005). A multivariate model was developed that included combined left and right coronary artery cross-sectional areas, right ventricular mass, and the ratio of combined coronary artery area-to-combined ventricular mass. This model also significantly (
p < 0.001) predicted instantaneous risk of death, and again larger covariate values were associated with longer survival. These results suggest that myocardial perfusion is an important determinant of survival in these infants.</description><subject>Age Factors</subject><subject>Aorta - pathology</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</subject><subject>Coronary Vessels - pathology</subject><subject>Heart</subject><subject>Heart Defects, Congenital - mortality</subject><subject>Heart Defects, Congenital - pathology</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Medical sciences</subject><subject>Myocardium - pathology</subject><subject>Retrospective Studies</subject><subject>Syndrome</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1989</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE2LFDEQhoMo67j6DxRyENFDayXpSSd7EJbFL1jxorC3kEkqTqS70yaZhfn3ZnaGOXpKpeqpl-Ih5CWD9wyY_AAAvFMDiLdKv9PQM9ndPSIrBnro5ND3j8nqjDwlz0r5076SK3lBLvjANUi2Ivn6N1JbqUdbtzTOtG6RbvdLWkZbanR0xFDpFm2utOxnn9OEV_T7bqzx3uZoa9ue7bgvsbTC0zgtKVc7O6QpPIS5lNNs8562CMwRy3PyJNix4IvTe0l-ff708-Zrd_vjy7eb69vOCSVr59eouBgcX0uAAFqHHlXrBMFCcFJsWocBctgoq3vfy2ZAST-sPSjbCykuyZtj7pLT3x2WaqZYHI6jnTHtihk0CMYUNLA_gi6nUjIGs-Q4tZMNA3NQbQ4ezcGjUdo8qDZ3be3VKX-3mdCfl05u2_z1aW6Ls2PIzUosZ2zga9Fr3rCPRwybi_uI2RQXsQn0MaOrxqf4_zv-Af8CmvA</recordid><startdate>19890601</startdate><enddate>19890601</enddate><creator>Lloyd, Thomas R.</creator><creator>Marvin, William J.</creator><general>Mosby, Inc</general><general>Elsevier</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>7X8</scope></search><sort><creationdate>19890601</creationdate><title>Age at death in the hypoplastic left heart syndrome: Multivariate analysis and importance of the coronary arteries</title><author>Lloyd, Thomas R. ; Marvin, William J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-d5e8237c25600f099f4e8823f31ffc63b99f10e20b8a94d4604186d75d08a4363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1989</creationdate><topic>Age Factors</topic><topic>Aorta - pathology</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</topic><topic>Coronary Vessels - pathology</topic><topic>Heart</topic><topic>Heart Defects, Congenital - mortality</topic><topic>Heart Defects, Congenital - pathology</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Medical sciences</topic><topic>Myocardium - pathology</topic><topic>Retrospective Studies</topic><topic>Syndrome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lloyd, Thomas R.</creatorcontrib><creatorcontrib>Marvin, William J.</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>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lloyd, Thomas R.</au><au>Marvin, William J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Age at death in the hypoplastic left heart syndrome: Multivariate analysis and importance of the coronary arteries</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>1989-06-01</date><risdate>1989</risdate><volume>117</volume><issue>6</issue><spage>1337</spage><epage>1343</epage><pages>1337-1343</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Survival analysis of 63 fatal cases of the hypoplastic left heart syndrome was undertaken to determine whether morphologic measurements related to coronary blood flow would predict the length of postnatal survival. Cross-sectional areas of the ascending aorta and proximal left and right coronary arteries, left and right ventricular mass, coronary artery dominance pattern, and the presence of discrete coarctation were determined from autopsy specimens. These values were used to construct survival functions using Cox regression. Survival was significantly prolonged in cases with larger cross-sectional areas of the left (
p < 0.005) and right (
p < 0.05) coronary arteries, right ventricular mass (
p < 0.005), and combined ventricular mass (
p < 0.005). A multivariate model was developed that included combined left and right coronary artery cross-sectional areas, right ventricular mass, and the ratio of combined coronary artery area-to-combined ventricular mass. This model also significantly (
p < 0.001) predicted instantaneous risk of death, and again larger covariate values were associated with longer survival. These results suggest that myocardial perfusion is an important determinant of survival in these infants.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>2729061</pmid><doi>10.1016/0002-8703(89)90416-X</doi><tpages>7</tpages></addata></record> |
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| ispartof | The American heart journal, 1989-06, Vol.117 (6), p.1337-1343 |
| issn | 0002-8703 1097-6744 |
| language | eng |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Age Factors Aorta - pathology Biological and medical sciences Cardiology. Vascular system Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava Coronary Vessels - pathology Heart Heart Defects, Congenital - mortality Heart Defects, Congenital - pathology Humans Infant Infant, Newborn Medical sciences Myocardium - pathology Retrospective Studies Syndrome |
| title | Age at death in the hypoplastic left heart syndrome: Multivariate analysis and importance of the coronary arteries |
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