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Background: Aortopulmonary collateral flow is considered to have significant impact on the outcome of patients with single ventricle circulation and total cavopulmonary connection (TCPC). There is little information on collateral flow during exercise.Purpose: To quantify aortopulmonary collateral flow at rest and during continuous submaximal exercise in clinical patients doing well with TCPC.Study Type: Prospective, case controlled.Population: Thirteen patients with TCPC (17 (11-37) years) and 13 age and sex-matched healthy controls (18 (11-38) years).Field Strength: 1.5T; free breathing; phase sensitive gradient echo sequence.Assessment: Blood flow in the ascending and descending aorta and superior vena cava were measured at rest and during continuous submaximal physical exercise in patients and controls. Systemic blood flow (Qs ) was assumed to be represented by the sum of flow in the superior caval vein (Qsvc ) and the descending aorta (QAoD ) at the diaphragm level. Aortopulmonary collateral flow (Qcoll ) was calculated by subtracting Qs from flow in the ascending aorta (QAoA ).Statistics: Mann-Whitney U-test and Wilcoxon test for comparison between groups and between rest and exercise.Results: Absolute collateral flow in TCPC patients at rest was 0.4 l/min/m2 (-0.1-1.2), corresponding to 14% (-2-42) of Qs . Collateral flow did not change during exercise (difference -0.01 (-0.7-1.0) l/min/m2 , P = 0.97). TCPC patients had significantly lower Qs at rest (2.5 (1.6-4.1) vs. 3.5 (2.6-4.8) l/min/m2 , P = 0.001) and during submaximal exercise (3.2 (2.0-6.0) vs. 4.8 (3.3-6.9) l/min/m2 , P = 0.001), compared to healthy controls. The increase in Qs with exercise was also significantly lower in patients than in healthy controls (median 0.6 vs. 1.2 l/min/m2 , P < 0.02).Data Conclusion: Clinical patients doing well with TCPC have significant aortopulmonary collateral flow at rest (14% of Qs ) compared to healthy controls, which does not change during submaximal exercise.Level Of Evidence: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1509-1516. [ABSTRACT FROM AUTHOR]

Carotid to femoral pulse wave velocity (PWV) is associated with an increase in cardiovascular morbidity and all-cause mortality. Noninvasive approach has made this method applicable for the examination of larger populations. This study aimed to obtain reference values of PWV measured with the Vicorder device. PWV was obtained using the oscillometric Vicorder in 318 healthy, normotensive patients (165 women, 28.7±17.6 years, range 6-83 years). A plethysmographic sensor was placed over the right carotid region to pick up the carotid pulse wave and a blood pressure cuff was placed around the upper thigh to trace the femoral pulse wave. Path length was defined as the distance from the suprasternal notch to the top of the thigh cuff. Mean PWV was 6.1±1.4 m/s and significantly increased with age ( r=.842; P<.0001). PWV was associated with mean arterial pressure ( r=.546; P<.0001) and body mass index ( r=.396; P<.0001). In a multiple linear regression model, age, mean arterial pressure, and body height emerged as independent markers for PWV. This study established reference values for carotid to femoral PWV derived by oscillometric measures that can now be used for risk stratification. J Clin Hypertens (Greenwich). 2012; 00:00-00 ©2012 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]