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9. Multimodality Imaging of Right Heart Function

Author

Hahn, Rebecca T., primary, Lerakis, Stamatios, additional, Delgado, Victoria, additional, Addetia, Karima, additional, Burkhoff, Daniel, additional, Muraru, Denisa, additional, Pinney, Sean, additional, and Friedberg, Mark K., additional

Published
2023
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19. Reversal of right ventricular pressure loading improves biventricular function independent of fibrosis in a rabbit model of pulmonary artery banding

Author

Fujioka, Tao, primary, Akazawa, Yohei, additional, Ide, Haruki, additional, Karur, Gauri Rani, additional, Bannan, Badr, additional, Grosse‐Wortmann, Lars, additional, Sun, Mei, additional, Hui, Wei, additional, Slorach, Cameron, additional, Honjo, Osami, additional, and Friedberg, Mark K., additional

Published
2022
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24. Prospective Assessment of Coronary Artery Flows Before and After Cardiopulmonary Bypass in Children With a Spectrum of Congenital Heart Disease

Author

Nield, Lynne E., primary, Morgan, Conall T., additional, Diab, Simone, additional, Vera, Maria Angeles, additional, Runeckles, Kyle, additional, Friedberg, Mark K., additional, Dragulescu, Andreea, additional, Honjo, Osami, additional, Taylor, Katherine, additional, Moga, Michael-Alice, additional, Manlhiot, Cedric, additional, Miner, Steven E.S., additional, and Mertens, Luc, additional

Published
2022
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31. Abstract 13735: Classic Pattern Dyssynchrony Score: A Predictor of Response to Cardiac Resynchronization Therapy in Pediatric and Congenital Heart Disease

Author

Chubb, Henry, primary, Dubin, Anne M, additional, Lopez, Leo, additional, Klas, Berthold, additional, Kaplinski, Michelle, additional, Ceresnak, Scott R, additional, Motonaga, Kara, additional, Goodyer, William R, additional, Trela, Anthony, additional, Hanisch, Deb, additional, McElhinney, Doff B, additional, and Friedberg, Mark K, additional

Published
2021
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34. Classic-Pattern Dyssynchrony Is Associated with Outcome in Patients with Fontan Circulation

Author

Rosner, Assami, Diab, Simone Goa, McElhinney, Doff B., Friedberg, Mark K., and Lui, George K.

Subjects
Adult, Heart Defects, Congenital, Cross-Sectional Studies, Treatment Outcome, Adolescent, Heart Ventricles, Protein-Losing Enteropathies, Humans, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, Child, Fontan Procedure, Retrospective Studies
Abstract

Background - Morbidity and mortality increase as Fontan patients age into adulthood. Limited studies have examined cardiac magnetic resonance and echocardiographic parameters to predict death and transplantation in children after the Fontan operation. The aim of this study was to investigate echocardiographic parameters in adolescents and adults after Fontan operation, including myocardial mechanics such as classic-pattern dyssynchrony (CPD), as predictors of transplantation or death. Methods - In a cross-sectional retrospective study, strain analysis was performed on echocardiographic studies performed between 2001 and 2015 on 110 patients with single-ventricle physiology after the Fontan procedure. Strain curves were measured and visually assessed for the presence of CPD. The primary end point was death or transplantation after a follow-up period of 85 ± 35 months after echocardiography. Results - The median age at the date of echocardiography was 20 years (range, 3-45 years). Of 110 patients, 28 had undergone transplantation. During the study period, three patients died after transplantation and seven patients died without undergoing transplantation. CPD was seen in 16 and protein-losing enteropathy in 21 of 110 patients. On multivariate analysis, CPD (hazard ratio [HR], 9.4; 95% confidence interval [CI], 2.6-34.6), protein-losing enteropathy (HR, 10.6; 95% CI, 3.4-33.2), systolic blood pressure (HR, 0.954; 95% CI, 0.913-0.996), systolic/diastolic duration ratio (HR, 6.83; 95% CI, 1.33-35.0), and E-wave deceleration time (HR, 0.98; 95% CI, 0.97-0.99) were independently associated with the primary end point. Conclusions - CPD, protein-losing enteropathy, and systolic and diastolic ventricular dysfunction are significantly associated with transplantation or death in Fontan-operated patients. In selected patients, the presence of CPD may be a basis to investigate cardiac resynchronization therapy as a treatment strategy.

Published
2021

35. The stressed right ventricle and its impact on the left ventricle

Author

Friedberg, Mark K., Prinzen, Frits, Lumens, Joost, Meijboom, F.J., RS: Carim - H06 Electro mechanics, and Fysiologie

Subjects
electromechanical dyssynchrony, right ventricular pressure-loading, right ventricle, ventricular-ventricular interaction
Abstract

The heart’s job is to pump blood, which it does through contraction of the heart muscle. The right heart ventricle (RV) pumps blood to the lungs, the left ventricle (LV) pumps to the body. Pulmonary hypertension (PAH) is a fatal disease in which the RV fails (the muscle tires out) from having to pump against too much pressure. Tetralogy of Fallot (TOF) is a disease that reduces life quality and expectancy because the RV fails from too much blood volume. Current therapies focus almost entirely on reducing lung pressures or RV volume but are limited. While PAH and TOF are traditionally considered ‘right heart’ diseases, LV function also determines how well patients do. However, it is not exactly understood how the RV harms the LV and how the apparently paradoxical effect of increasing LV pressure reduces its injury. This knowledge is vital to apply new therapies. While many investigators believe that the stressed RV just exerts pressure on the LV to reduce its filling (think of a large crowd in a bus pushing passengers towards the door), this researcher thinks that the damage is more profound, extending to muscle injury (think of people being crushed). While current therapies akin to opening the bus door may improve the situation, they have not been enough to truly treat it (opening the bus door would not be ample to resuscitate crushed and injured passengers). This thesis investigates the mechanical and molecular mechanisms driving injury in the stressed RV and how these impact the LV.

Published
2021

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