Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Koestenberger, M; Sallmon, H; Avian, A; Cantinotti, M; Gamillscheg, A; Kurath-Koller, S; Schweintzger, S; Hansmann, G.
Ventricular-ventricular interaction variables correlate with surrogate variables of clinical outcome in children with pulmonary hypertension.
Pulm Circ. 2019; 9(2): 2045894019854074-2045894019854074.
Doi: 10.1177/2045894019854074
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- Führende Autor*innen der Med Uni Graz
- Koestenberger Martin
- Co-Autor*innen der Med Uni Graz
- Avian Alexander
- Gamillscheg Andreas
- Kurath-Koller Stefan
- Sallmon Hannes
- Schweintzger Sabrina
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- Abstract:
- Determination of biventricular dimensions, function, and ventricular-ventricular interactions (VVI) is an essential part of the echocardiographic examination in adults with pulmonary hypertension (PH); however, data from according pediatric studies are sparse. We hypothesized that left and right heart dimensions/function and VVI variables indicate disease severity and progression in children with PH. Left heart, right heart, and VVI variables (e.g. end-systolic LV eccentricity index [LVEI], right ventricular [RV]/left ventricular [LV] dimension ratio) were echocardiographically determined in 57 children with PH, and correlated with New York Heart Association (NYHA) functional class (FC), N-terminal-pro brain natriuretic peptide (NT-proBNP), and invasive hemodynamic variables (e.g. pulmonary vascular resistance index [PVRi]). Clinically sicker patients (higher NYHA FC) had lower LV ejection fraction (LVEF) and higher LVEI - a surrogate of LV compression. In PH children, the ratio of systolic pulmonary arterial pressure divided by systolic systemic arterial pressure (sPAP/sSAP) and the PVRi correlated well with the LVEI ( P < 0.001). Patients with more severe PH (sPAP/sSAP ratio, PVRi) had increased RV/LV and right-to-left atrial dimension ratios ( P < 0.01). When stratified using NYHA-FC, sicker PH children had greater RV and right atrial dimensions with lower exercise capacity, while the tricuspid annular plane systolic excursion as surrogate for longitudinal systolic RV function decreased. Consistent with previous studies, serum NT-proBNP correlated with both, sPAP/sSAP ratio ( P < 0.001) and NYHA FC ( P < 0.01). Taken together, the VVI variables LVEI and RV/LV dimension ratio are associated with lower FC, worse hemodynamics, and higher NT-proBNP levels, thus highlighting the importance of ventricular interdependence in pediatric PH.
- Find related publications in this database (Keywords)
- left ventricular eccentricity index
- New York Health Association functional class
- pediatric pulmonary hypertension
- ventricular-ventricular interactions