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Longitudinal function and ventricular dyssynchrony are restored in children with pulmonary stenosis after percutaneous balloon pulmonary valvuloplasty

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Abstract

The aim of this study was to evaluate the impact of balloon pulmonary valvuloplasty on longitudinal ventricular dysfunction and cardiac dyssynchrony in children with congenital moderately severe pulmonary stenosis (PS). Forty-eight children with congenital moderately severe valvular pulmonary stenosis and 36 age-matched normal children were included. Successful percutaneous balloon pulmonary valvuloplasty was performed for children with PS. Longitudinal Cardiac function and myocardial synchrony was assessed by echocardiography with tissue Doppler imaging (TDI). Mitral annular plane excursion (MAPSE), tricuspid annular plane excursion (TAPSE), left ventricular systolic wave (LVs), right ventricular systolic wave (RVs) and myocardial synchrony was assessed by echocardiography with TDI. TAPSE, RVs, TAPSE/MAPSE ratio and RVs/LVs ratio were significantly lower in children with PS compared to control subjects: (P < 0.001, P < 0.001, P < 0.001 and P < 0.001). All these parameters were significantly improved after balloon valvuloplasty in children with PS. Intra& inter-ventricular dyssynchrony were significantly increased in PS patients than in control group, (P < 0.03, <0.001 and 0.02 respectively). All these variables were significantly reduced after pulmonary valvuloplasty. In children with valvular PS, balloon valvuloplasty restored longitudinal function and cardiac Synchrony. This gives good insights for the importance of early intervention in children with PS to prevent the progression for cardiac deformation.

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References

  1. Werynski P, Rudzinski A, Krol-Jawien W, Kuzma J (2009) Percutaneous balloon valvuloplasty for the treatment of pulmonary valve stenosis in children-a single centre experience. Kardiol Pol 67(4):369–375

    PubMed  Google Scholar 

  2. Fedderly RT, Beekman RH (1995) 3rd Balloon valvuloplasty for pulmonary valve stenosis. J Interv Cardiol 8(5):451–461

    Article  CAS  PubMed  Google Scholar 

  3. Carlsson M, Ugander M, Heiberg E et al (2007) The quantitative relationship between longitudinal and radial function in left, right, and total heart pumping in humans. Am J Physiol Heart Circ Physiol 293:H636–H644. doi:10.1152/ajpheart.01376.2006

    Article  CAS  PubMed  Google Scholar 

  4. Carlsson M, Ugander M, Mosen H et al (2007) Atrioventricular plane displacement is the major contributor to left ventricular pumping in healthy adults, athletes, and patients with dilated cardiomyopathy. Am J Physiol Heart Circ Physiol 292:H1452–H1459

    Article  CAS  PubMed  Google Scholar 

  5. Salehian O, Burwash IG, Chan KL, Beauchesne LM (2008) Tricuspid annular systolic velocity predicts maximal oxygen consumption during exercise in adult patients with repaired tetralogy of Fallot. J Am Soc Echocardiogr 21:342–346

    Article  PubMed  Google Scholar 

  6. Bader H, Garrigue S, Lafitte S et al (2004) Intra-left ventricular electromechanical asynchrony. A new independent predictor of severe cardiac events in heart failure patients. J Am Coll Cardiol 43:248–256

    Article  PubMed  Google Scholar 

  7. Korosoglou G, Humpert PM, Halbgewachs E et al (2006) Evidence of left ventricular contractile asynchrony by echocardiographic phase imaging in patients with type 2 diabetes mellitus and without clinically evident heart disease. Am J Cardiol 98:1525–1530

    Article  PubMed  Google Scholar 

  8. Chang SA, Kim HK, Kim DH et al (2009) Left ventricular systolic and diastolic dyssynchrony in asymptomatic hypertensive patients. J Am Soc Echocardiogr 22:337–342

    Article  PubMed  Google Scholar 

  9. Delcour KS, Tejwani L, Hayden MR, Govindarajan G (2007) Intraventricular mechanical asynchrony in asymptomatic morbidly obese individuals. J Cardiometab Syndr 2:305–308

    Article  PubMed  Google Scholar 

  10. Purushottam B, Parameswaran AC, Figueredo VM (2011) Dyssynchrony in obese subjects without a history of cardiac disease using velocity vector imaging. J Am Soc Echocardiogr 24:98–106

    Article  PubMed  Google Scholar 

  11. Marfella R, Esposito K, Siniscalchi M et al (2004) Effect of weight loss on cardiac synchronization and proinflammatory cytokines in premenopausal obese women. Diabetes Care 27:47–52

    Article  CAS  PubMed  Google Scholar 

  12. Radtke W, Keane JF, Fellows KE, Lang P, Lock JE (1986) Percutaneous balloon valvotomy of congenital pulmonary stenosis using oversized balloons. J Am Coll Cardiol 8:909–915

    Article  CAS  PubMed  Google Scholar 

  13. Kan JS, White RI Jr, Mitchell SE, Gardner TJ (1982) Percutaneous balloon valvuloplasty: a new method for treating congenital pulmonary-valve stenosis. N Engl J Med 307:540–542

    Article  CAS  PubMed  Google Scholar 

  14. Ring JC, Kulik TJ, Burke BA, Lock JE (1985) Morphologic changes induced by dilation of the pulmonary valve annulus with overlarge balloons in normal newborn lambs. Am J Cardiol 55:210–214

    Article  CAS  PubMed  Google Scholar 

  15. Tumuklu MM, Etikan I, Kisacik B, Kayikcioglu M (2007) Effect of obesity on left ventricular structure and myocardial systolic function: assessment by tissue Doppler imaging and strain/strain rate imaging. Echocardiography 24:802–809

    Article  PubMed  Google Scholar 

  16. Kosmala W, O’Moore-Sullivan T, Plaksej R, Przewlocka-Kosmala M, Marwick TH (2009) Improvement of left ventricular function by lifestyle intervention in obesity: contributions of weight loss and reduced insulin resistance. Diabetologia 52:2306–2316

    Article  CAS  PubMed  Google Scholar 

  17. Orhan AL, Uslu N, Dayi SU et al (2010) Effects of isolated obesity on left and right ventricular function: a tissue Doppler and strain rate imaging study. Echocardiography 27:236–243

    Article  PubMed  Google Scholar 

  18. Aburawi EH, Berg A, and Pesonen E. (2009) Effects of balloon valvuloplasty on coronary blood flow in neonates with critical pulmonary valve stenosis assessed with transthoracic Doppler echocardiography. J Am Soc Echocardiogr 22:165–169

    Article  PubMed  Google Scholar 

  19. Cleland JG, Daubert JC, Erdmann E et al, Cardiac Resynchronization-Heart Failure (CARE-HF) Study Investigators (2005) The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 352:1539–1549

    Article  CAS  PubMed  Google Scholar 

  20. AlJaroudi W, Aggarwal H, Venkataraman R et al (2010) Impact of left ventricular dyssynchrony by phase analysis on cardiovascular outcomes in patients with end-stage renal disease. J Nucl Cardiol 17:1058–1064

    Article  PubMed  Google Scholar 

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Correspondence to Tamer M. Moustafa.

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Mahfouz, R.A., Moustafa, T.M., Gouda, M. et al. Longitudinal function and ventricular dyssynchrony are restored in children with pulmonary stenosis after percutaneous balloon pulmonary valvuloplasty. Int J Cardiovasc Imaging 33, 533–538 (2017). https://doi.org/10.1007/s10554-016-1036-4

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  • DOI: https://doi.org/10.1007/s10554-016-1036-4

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