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Pulmonary endarterectomy normalizes interventricular dyssynchrony and right ventricular systolic wall stress.
- Source :
-
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance [J Cardiovasc Magn Reson] 2012 Jan 12; Vol. 14, pp. 5. Date of Electronic Publication: 2012 Jan 12. - Publication Year :
- 2012
-
Abstract
- Background: Interventricular mechanical dyssynchrony is a characteristic of pulmonary hypertension. We studied the role of right ventricular (RV) wall stress in the recovery of interventricular dyssynchrony, after pulmonary endarterectomy (PEA) in chronic thromboembolic pulmonary hypertension (CTEPH).<br />Methods: In 13 consecutive patients with CTEPH, before and 6 months after pulmonary endarterectomy, cardiovascular magnetic resonance myocardial tagging was applied. For the left ventricular (LV) and RV free walls, the time to peak (Tpeak) of circumferential shortening (strain) was calculated. Pulmonary Artery Pressure (PAP) was measured by right heart catheterization within 48 hours of PEA. Then the RV free wall systolic wall stress was calculated by the Laplace law.<br />Results: After PEA, the left to right free wall delay (L-R delay) in Tpeak strain decreased from 97 ± 49 ms to -4 ± 51 ms (P < 0.001), which was not different from normal reference values of -35 ± 10 ms (P = 0.18). The RV wall stress decreased significantly from 15.2 ± 6.4 kPa to 5.7 ± 3.4 kPa (P < 0.001), which was not different from normal reference values of 5.3 ± 1.39 kPa (P = 0.78). The reduction of L-R delay in Tpeak was more strongly associated with the reduction in RV wall stress (r = 0.69,P = 0.007) than with the reduction in systolic PAP (r = 0.53, P = 0.07). The reduction of L-R delay in Tpeak was not associated with estimates of the reduction in RV radius (r = 0.37,P = 0.21) or increase in RV systolic wall thickness (r = 0.19,P = 0.53).<br />Conclusion: After PEA for CTEPH, the RV and LV peak strains are resynchronized. The reduction in systolic RV wall stress plays a key role in this resynchronization.
- Subjects :
- Adult
Aged
Aged, 80 and over
Biomechanical Phenomena
Blood Pressure
Cardiac Catheterization
Chronic Disease
Female
Humans
Hypertension, Pulmonary etiology
Hypertension, Pulmonary physiopathology
Linear Models
Magnetic Resonance Imaging, Cine
Male
Middle Aged
Models, Cardiovascular
Netherlands
Pulmonary Artery physiopathology
Pulmonary Embolism complications
Pulmonary Embolism physiopathology
Recovery of Function
Stress, Mechanical
Stroke Volume
Systole
Time Factors
Treatment Outcome
Ventricular Dysfunction, Left etiology
Ventricular Dysfunction, Right etiology
Endarterectomy
Hypertension, Pulmonary surgery
Pulmonary Artery surgery
Ventricular Dysfunction, Left physiopathology
Ventricular Dysfunction, Right physiopathology
Ventricular Function, Left
Ventricular Function, Right
Subjects
Details
- Language :
- English
- ISSN :
- 1532-429X
- Volume :
- 14
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
- Publication Type :
- Academic Journal
- Accession number :
- 22240072
- Full Text :
- https://doi.org/10.1186/1532-429X-14-5