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Can we use the end systolic volume index to monitor intrinsic right ventricular function after repair of tetralogy of Fallot?
Int J Cardiol. 2011 Feb 17; 147(1):52-7.IJ

Abstract

BACKGROUND

After tetralogy of Fallot (ToF) repair the right ventricle (RV) is commonly exposed to abnormal volume load resulting from pulmonary regurgitation (PR) leading to progressive RV dilatation. The objective of this study was to assess the relationship between RV volumes, especially the end systolic volume index (ESVi), and RV contractility in patients after ToF repair and significant PR and to determine whether RV dilatation reflects intrinsic RV dysfunction in these patients.

METHODS

Twenty-nine ToF patients were studied 11.6 (range: 1.9-30.1) years after repair with the pressure-volume conductance system. The patient cohort was divided into two groups according to the median ESVi (group 1: ESVi<34.7 ml/m(2)(×1.18), n = 14; group 2: ESVi ≥ 34.7 ml/m(2)(×1.18), n = 15).

RESULTS

The slope of the end systolic pressure-volume relationship (end systolic elastance, Ees) was higher in group 1 compared to group 2 both at baseline and during dobutamine infusion (0.87 ± 0.36 vs. 0.46 ± 0.28 mm Hg/ml and 1.50 ± 0.77 vs. 0.92 ± 0.37 mm Hg/ml; P<0.005 and P = 0.02, respectively). Overall, Ees at baseline correlated significantly with ESVi and also with the end diastolic volume index (r = -0.64, and P<0.001 for both). Receiver operating characteristic curve analysis revealed that ESVi was superior to RV ejection fraction (EF) in predicting an Ees in the lowest quartile of the study group (area under curve ESVi vs. EF: 0.84 (0.64-0.95) vs. 0.68 (0.47-0.85); P = 0.015).

CONCLUSION

ESVi is a valid estimate of intrinsic RV function in repaired ToF patients with residual PR and in this respect seems superior to EF. These data underscore the importance of serial ventricular volume assessment in the follow-up of these patients.

Authors+Show Affiliations

Department of Paediatric Cardiology, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str.3, Haus 9, 24105 Kiel, Germany. uebing@pedcard.uni-kiel.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19716612

Citation

Uebing, Anselm, et al. "Can We Use the End Systolic Volume Index to Monitor Intrinsic Right Ventricular Function After Repair of Tetralogy of Fallot?" International Journal of Cardiology, vol. 147, no. 1, 2011, pp. 52-7.
Uebing A, Fischer G, Schlangen J, et al. Can we use the end systolic volume index to monitor intrinsic right ventricular function after repair of tetralogy of Fallot? Int J Cardiol. 2011;147(1):52-7.
Uebing, A., Fischer, G., Schlangen, J., Apitz, C., Steendijk, P., & Kramer, H. H. (2011). Can we use the end systolic volume index to monitor intrinsic right ventricular function after repair of tetralogy of Fallot? International Journal of Cardiology, 147(1), 52-7. https://doi.org/10.1016/j.ijcard.2009.07.031
Uebing A, et al. Can We Use the End Systolic Volume Index to Monitor Intrinsic Right Ventricular Function After Repair of Tetralogy of Fallot. Int J Cardiol. 2011 Feb 17;147(1):52-7. PubMed PMID: 19716612.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Can we use the end systolic volume index to monitor intrinsic right ventricular function after repair of tetralogy of Fallot? AU - Uebing,Anselm, AU - Fischer,Gunther, AU - Schlangen,Jana, AU - Apitz,Christian, AU - Steendijk,Paul, AU - Kramer,Hans-Heiner, Y1 - 2009/08/28/ PY - 2009/06/23/received PY - 2009/07/24/accepted PY - 2009/9/1/entrez PY - 2009/9/1/pubmed PY - 2011/12/28/medline SP - 52 EP - 7 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 147 IS - 1 N2 - BACKGROUND: After tetralogy of Fallot (ToF) repair the right ventricle (RV) is commonly exposed to abnormal volume load resulting from pulmonary regurgitation (PR) leading to progressive RV dilatation. The objective of this study was to assess the relationship between RV volumes, especially the end systolic volume index (ESVi), and RV contractility in patients after ToF repair and significant PR and to determine whether RV dilatation reflects intrinsic RV dysfunction in these patients. METHODS: Twenty-nine ToF patients were studied 11.6 (range: 1.9-30.1) years after repair with the pressure-volume conductance system. The patient cohort was divided into two groups according to the median ESVi (group 1: ESVi<34.7 ml/m(2)(×1.18), n = 14; group 2: ESVi ≥ 34.7 ml/m(2)(×1.18), n = 15). RESULTS: The slope of the end systolic pressure-volume relationship (end systolic elastance, Ees) was higher in group 1 compared to group 2 both at baseline and during dobutamine infusion (0.87 ± 0.36 vs. 0.46 ± 0.28 mm Hg/ml and 1.50 ± 0.77 vs. 0.92 ± 0.37 mm Hg/ml; P<0.005 and P = 0.02, respectively). Overall, Ees at baseline correlated significantly with ESVi and also with the end diastolic volume index (r = -0.64, and P<0.001 for both). Receiver operating characteristic curve analysis revealed that ESVi was superior to RV ejection fraction (EF) in predicting an Ees in the lowest quartile of the study group (area under curve ESVi vs. EF: 0.84 (0.64-0.95) vs. 0.68 (0.47-0.85); P = 0.015). CONCLUSION: ESVi is a valid estimate of intrinsic RV function in repaired ToF patients with residual PR and in this respect seems superior to EF. These data underscore the importance of serial ventricular volume assessment in the follow-up of these patients. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/19716612/Can_we_use_the_end_systolic_volume_index_to_monitor_intrinsic_right_ventricular_function_after_repair_of_tetralogy_of_Fallot L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(09)00839-0 DB - PRIME DP - Unbound Medicine ER -