Adverse ventricular–ventricular interactions in right ventricular pressure load: Insights from pediatric pulmonary hypertension versus pulmonary stenosis

Right ventricular (RV) pressure overload has a vastly different clinical course in children with idiopathic pulmonary arterial hypertension (iPAH) than in children with pulmonary stenosis (PS). While RV function is well recognized as a key prognostic factor in iPAH, adverse ventricular–ventricular i...

Full description

Saved in:
Bibliographic Details
Published in:Physiological reports 2016-06, Vol.4 (11), p.e12833-n/a
Main Authors: Driessen, Mieke M. P., Hui, Wei, Bijnens, Bart H., Dragulescu, Andreea, Mertens, Luc, Meijboom, Folkert J., Friedberg, Mark K.
Format: Article
Language:English
Subjects:
Adolescent
Blood Pressure
Cardiovascular Conditions, Disorders and Treatments
Child
Child, Preschool
Children
Contraction
Doppler effect
Dyskinesia
Echocardiography
Echocardiography, Doppler
Female
Geometry
Heart
Heart Ventricles - physiopathology
Humans
Hypertension
Hypertension, Pulmonary - physiopathology
Male
Mechanics
Original Research
Pediatrics
Physiology
Pulmonary hypertension
pulmonary stenosis
Pulmonary Valve Stenosis - physiopathology
Retrospective Studies
Stenosis
Studies
Ultrasonic imaging
Ventricle
Ventricular Dysfunction, Right - physiopathology
Ventricular Function, Right - physiology
Ventricular Pressure - physiology
ventricular–ventricular interaction
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Right ventricular (RV) pressure overload has a vastly different clinical course in children with idiopathic pulmonary arterial hypertension (iPAH) than in children with pulmonary stenosis (PS). While RV function is well recognized as a key prognostic factor in iPAH, adverse ventricular–ventricular interactions and LV dysfunction are less well characterized and the pathophysiology is incompletely understood. We compared ventricular–ventricular interactions as hypothesized drivers of biventricular dysfunction in pediatric iPAH versus PS. Eighteen iPAH, 16 PS patients and 18 age‐ and size‐matched controls were retrospectively studied. Cardiac cycle events were measured by M‐mode and Doppler echocardiography. Measurements were compared between groups using ANOVA with post hoc Dunnet's or ANCOVA including RV systolic pressure (RVSP; iPAH 96.8 ± 25.4 mmHg vs. PS 75.4 ± 18.9 mmHg; P = 0.011) as a covariate. RV‐free wall thickening was prolonged in iPAH versus PS, extending beyond pulmonary valve closure (638 ± 76 msec vs. 562 ± 76 msec vs. 473 ± 59 msec controls). LV and RV isovolumetric relaxation were prolonged in iPAH (P 
ISSN:2051-817X
2051-817X
DOI:10.14814/phy2.12833