Global myocardial function is compromised in infants with pulmonary hypertension
Aim: Persistent pulmonary hypertension of the newborn is a serious clinical entity with significant mortality and long‐term morbidity. The objective was to study the profile of myocardial function, especially diastolic function, in term infants with pulmonary hypertension treated with nitric oxide....
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| Veröffentlicht in: | Acta Paediatrica 2012-04, Vol.101 (4), p.410-413 |
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| creator | Sehgal, Arvind Athikarisamy, Sam E Adamopoulos, Maria |
| description | Aim: Persistent pulmonary hypertension of the newborn is a serious clinical entity with significant mortality and long‐term morbidity. The objective was to study the profile of myocardial function, especially diastolic function, in term infants with pulmonary hypertension treated with nitric oxide.
Methods: Unit electronic database was accessed to identify infants ≥34 weeks gestation who were administered nitric oxide for pulmonary hypertension over the last 6 years. Medical records and archived echocardiographic images were retrieved. Those with no echocardiogram on the day of administration of nitric oxide, concomitant congenital heart disease or ≥2 weeks of age at the time of nitric administration were excluded.
Results: Low biventricular outputs were noted in >2/3rd infants. Tricuspid regurgitation was noted in 20/25 (80%) infants, and ductal shunt was bidirectional in the majority of cases. Right ventricular diastolic function was assessed by systolic to diastolic duration ratio; dysfunction was widely prevalent.
Conclusions: A large percentage of infants were haemodynamically severely compromised. This is the first study to detail right ventricular diastolic dysfunction in infants with pulmonary hypertension and highlights the therapeutic role of milrinone, a lusitropic drug with myocardial relaxation properties. Comprehensive evaluation of cardiovascular haemodynamics can optimize clinical care. |
| doi_str_mv | 10.1111/j.1651-2227.2011.02572.x |
| format | Article |
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Methods: Unit electronic database was accessed to identify infants ≥34 weeks gestation who were administered nitric oxide for pulmonary hypertension over the last 6 years. Medical records and archived echocardiographic images were retrieved. Those with no echocardiogram on the day of administration of nitric oxide, concomitant congenital heart disease or ≥2 weeks of age at the time of nitric administration were excluded.
Results: Low biventricular outputs were noted in >2/3rd infants. Tricuspid regurgitation was noted in 20/25 (80%) infants, and ductal shunt was bidirectional in the majority of cases. Right ventricular diastolic function was assessed by systolic to diastolic duration ratio; dysfunction was widely prevalent.
Conclusions: A large percentage of infants were haemodynamically severely compromised. This is the first study to detail right ventricular diastolic dysfunction in infants with pulmonary hypertension and highlights the therapeutic role of milrinone, a lusitropic drug with myocardial relaxation properties. Comprehensive evaluation of cardiovascular haemodynamics can optimize clinical care.</description><identifier>ISSN: 0803-5253</identifier><identifier>EISSN: 1651-2227</identifier><identifier>DOI: 10.1111/j.1651-2227.2011.02572.x</identifier><identifier>PMID: 22181690</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Biological and medical sciences ; Cardiovascular system ; Diastole - physiology ; Drug therapy ; Echocardiography ; General aspects ; Heart - physiology ; Humans ; Hypertension, Pulmonary - drug therapy ; Hypertension, Pulmonary - physiopathology ; Infant, Newborn ; Investigative techniques, diagnostic techniques (general aspects) ; Medical sciences ; Nitric oxide ; Nitric Oxide - therapeutic use ; Pneumology ; Pulmonary hypertension ; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases ; Retrospective Studies ; Treatment Outcome ; Ultrasonic investigative techniques ; Vasodilator Agents - therapeutic use</subject><ispartof>Acta Paediatrica, 2012-04, Vol.101 (4), p.410-413</ispartof><rights>2011 The Author(s)/Acta Pædiatrica © 2011 Foundation Acta Pædiatrica</rights><rights>2015 INIST-CNRS</rights><rights>2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4642-2921aa83da303e51ee5ed95423d73aa8221b55f5f1e721419b90eda3b85f91ef3</citedby><cites>FETCH-LOGICAL-c4642-2921aa83da303e51ee5ed95423d73aa8221b55f5f1e721419b90eda3b85f91ef3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1651-2227.2011.02572.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1651-2227.2011.02572.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,782,786,1419,27931,27932,45581,45582</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25646668$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22181690$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sehgal, Arvind</creatorcontrib><creatorcontrib>Athikarisamy, Sam E</creatorcontrib><creatorcontrib>Adamopoulos, Maria</creatorcontrib><title>Global myocardial function is compromised in infants with pulmonary hypertension</title><title>Acta Paediatrica</title><addtitle>Acta Paediatr</addtitle><description>Aim: Persistent pulmonary hypertension of the newborn is a serious clinical entity with significant mortality and long‐term morbidity. The objective was to study the profile of myocardial function, especially diastolic function, in term infants with pulmonary hypertension treated with nitric oxide.
Methods: Unit electronic database was accessed to identify infants ≥34 weeks gestation who were administered nitric oxide for pulmonary hypertension over the last 6 years. Medical records and archived echocardiographic images were retrieved. Those with no echocardiogram on the day of administration of nitric oxide, concomitant congenital heart disease or ≥2 weeks of age at the time of nitric administration were excluded.
Results: Low biventricular outputs were noted in >2/3rd infants. Tricuspid regurgitation was noted in 20/25 (80%) infants, and ductal shunt was bidirectional in the majority of cases. Right ventricular diastolic function was assessed by systolic to diastolic duration ratio; dysfunction was widely prevalent.
Conclusions: A large percentage of infants were haemodynamically severely compromised. This is the first study to detail right ventricular diastolic dysfunction in infants with pulmonary hypertension and highlights the therapeutic role of milrinone, a lusitropic drug with myocardial relaxation properties. Comprehensive evaluation of cardiovascular haemodynamics can optimize clinical care.</description><subject>Biological and medical sciences</subject><subject>Cardiovascular system</subject><subject>Diastole - physiology</subject><subject>Drug therapy</subject><subject>Echocardiography</subject><subject>General aspects</subject><subject>Heart - physiology</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - drug therapy</subject><subject>Hypertension, Pulmonary - physiopathology</subject><subject>Infant, Newborn</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Medical sciences</subject><subject>Nitric oxide</subject><subject>Nitric Oxide - therapeutic use</subject><subject>Pneumology</subject><subject>Pulmonary hypertension</subject><subject>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Ultrasonic investigative techniques</subject><subject>Vasodilator Agents - therapeutic use</subject><issn>0803-5253</issn><issn>1651-2227</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE9v1DAQxS0EokvhK6BICHFK8H8nBw6rim6pqlIJqkq9WE4yVr0kztZO1N1vj8NuF4kTvng083v2m4dQRnBB0vm8LogUJKeUqoJiQgpMhaLF9gVaHAcv0QKXmOWCCnaC3sS4xpiyisvX6IRSUhJZ4QW6WXVDbbqs3w2NCa1LpZ18M7rBZy5mzdBvwtC7CG3mUsdb48eYPbnxIdtMXT94E3bZw24DYQQfk-otemVNF-Hd4T5Ft-dff55d5FffV9_Olld5wyWnOa0oMaZkrWGYgSAAAtpKcMpaxdIgOayFsMISUJRwUtUVhgTXpbAVActO0af9u8nf4wRx1MllA11nPAxT1BWVAkvFeSI__EOuhyn4ZE4TwXmppBI4UeWeasIQYwCrN8H1aTtNsJ5D12s9Z6vnbPUcuv4Tut4m6fvDB1PdQ3sUPqecgI8HwMTGdDYY37j4lxOSSynLxH3Zc0-ug91_G9DLm-VcJX2-17s4wvaoN-GXloopoe-uV_ruB7m4FPfX-pz9BrXBq-c</recordid><startdate>201204</startdate><enddate>201204</enddate><creator>Sehgal, Arvind</creator><creator>Athikarisamy, Sam E</creator><creator>Adamopoulos, Maria</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><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>7T5</scope><scope>7TK</scope><scope>7TM</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>7X8</scope></search><sort><creationdate>201204</creationdate><title>Global myocardial function is compromised in infants with pulmonary hypertension</title><author>Sehgal, Arvind ; Athikarisamy, Sam E ; Adamopoulos, Maria</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4642-2921aa83da303e51ee5ed95423d73aa8221b55f5f1e721419b90eda3b85f91ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Biological and medical sciences</topic><topic>Cardiovascular system</topic><topic>Diastole - physiology</topic><topic>Drug therapy</topic><topic>Echocardiography</topic><topic>General aspects</topic><topic>Heart - physiology</topic><topic>Humans</topic><topic>Hypertension, Pulmonary - drug therapy</topic><topic>Hypertension, Pulmonary - physiopathology</topic><topic>Infant, Newborn</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Medical sciences</topic><topic>Nitric oxide</topic><topic>Nitric Oxide - therapeutic use</topic><topic>Pneumology</topic><topic>Pulmonary hypertension</topic><topic>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. 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The objective was to study the profile of myocardial function, especially diastolic function, in term infants with pulmonary hypertension treated with nitric oxide.
Methods: Unit electronic database was accessed to identify infants ≥34 weeks gestation who were administered nitric oxide for pulmonary hypertension over the last 6 years. Medical records and archived echocardiographic images were retrieved. Those with no echocardiogram on the day of administration of nitric oxide, concomitant congenital heart disease or ≥2 weeks of age at the time of nitric administration were excluded.
Results: Low biventricular outputs were noted in >2/3rd infants. Tricuspid regurgitation was noted in 20/25 (80%) infants, and ductal shunt was bidirectional in the majority of cases. Right ventricular diastolic function was assessed by systolic to diastolic duration ratio; dysfunction was widely prevalent.
Conclusions: A large percentage of infants were haemodynamically severely compromised. This is the first study to detail right ventricular diastolic dysfunction in infants with pulmonary hypertension and highlights the therapeutic role of milrinone, a lusitropic drug with myocardial relaxation properties. Comprehensive evaluation of cardiovascular haemodynamics can optimize clinical care.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>22181690</pmid><doi>10.1111/j.1651-2227.2011.02572.x</doi><tpages>4</tpages></addata></record> |
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| subjects | Biological and medical sciences Cardiovascular system Diastole - physiology Drug therapy Echocardiography General aspects Heart - physiology Humans Hypertension, Pulmonary - drug therapy Hypertension, Pulmonary - physiopathology Infant, Newborn Investigative techniques, diagnostic techniques (general aspects) Medical sciences Nitric oxide Nitric Oxide - therapeutic use Pneumology Pulmonary hypertension Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases Retrospective Studies Treatment Outcome Ultrasonic investigative techniques Vasodilator Agents - therapeutic use |
| title | Global myocardial function is compromised in infants with pulmonary hypertension |
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