Right Ventricular Tei Index in Children: Effect of Method, Age, Body Surface Area, and Heart Rate

2007 ◽  
Vol 20 (6) ◽  
pp. 764-770 ◽  
Author(s):  
David A. Roberson ◽  
Wei Cui
Keyword(s):  
Heart Rate ◽  
Right Ventricular ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Tei Index

Abstract 16754: Novel Characterization of Pulmonary Artery Bending, Rather Than Stenosis, Detects Increased Right Ventricular Afterload and is Associated With Increased Right Ventricular Mass in the Post-Arterial Switch Operation Heart

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Marc A Delaney ◽  
Paige Mass ◽  
Francesco Capuano ◽  
Yue-hin Loke ◽  
Laura Olivieri
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricular ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Arterial Switch Operation ◽  
Radius Of Curvature ◽  
Transposition Of Great Arteries ◽  
Arterial Switch ◽  
Switch Operation

Introduction: Surgical treatment of transposition of great arteries involves the Arterial Switch Operation (ASO) and the LeCompte maneuver, where the pulmonary artery (PA) and its bifurcation are translocated anterior to the neoaortic root, creating relative PA stenosis and exaggerated PA bending. Assessment of branch PA dimensions can identify stenosis, however complex 3-dimensional bending without clear stenosis may contribute to elevated right ventricular (RV) afterload. Initial data suggest elevated RV afterload and RV mass are prevalent in these patients but the etiology and associated risk factors remain unclear. Hypothesis: In post-ASO patients, more extreme PA bending, as described by radius of curvature, will be associated with elevated RV afterload and RV mass independently of relative PA stenosis. Methods: Retrospective single-center analysis of 22 post-ASO patients was performed, representing native anatomy of D-TGA with (15, 68%) and without (7, 32%) intact ventricular septum, excluding those with PA stent, pulmonary hypertension, or other anatomical confounders. RV systolic pressure (RVSP) was recorded from echocardiography (11, 50%) or catheterization (11, 50%) and correlated to cardiac magnetic resonance (CMR) imaging measurements including: radius of curvature (Rcw) weighted to differential pulmonary blood flow and RV mass indexed to body surface area. Results: In ASO patients, receiver operating characteristic curve demonstrated Rcw, but not PA stenosis, moderately detected presence of elevated RVSP (>40 mmHg) (respectively: AUC 0.84, p = 0.03 and AUC 0.49, p =0.60). Patients with elevated RV Mass had more extreme Rcw (when normalized to body surface area), but no difference in PA stenosis via Nakata index (respectively: p = 0.10, p = 0.02). Conclusions: Abnormal PA bending as described by Rcw is associated with increased RV afterload and RV Mass. Rcw may serve as a promising future clinical proxy to RV afterload.

Shivering following cardiac surgery: predictive factors, consequences, and characteristics

1994 ◽  
Vol 3 (5) ◽  
pp. 356-367 ◽  
Author(s):  
SE Spaniol ◽  
EF Bond ◽  
GL Brengelmann ◽  
M Savage ◽  
RS Pozos
Keyword(s):  
Heart Rate ◽  
Cardiac Surgery ◽  
Arterial Pressure ◽  
Surface Area ◽  
Body Surface Area ◽  
Core Temperature ◽  
Body Surface ◽  
Rate Pressure Product ◽  
Early Recovery ◽  
Convenience Sample

BACKGROUND: Shivering is common after cardiac surgery and may evoke harmful hemodynamic changes. Neither those changes nor factors increasing probability of shivering are well defined. OBJECTIVES: (1) To identify factors linked with risk of shivering by comparing age, weight, body surface area, gender, intraoperative details, anesthetics, postoperative temperatures, hemodynamics, and therapeutics in shivering vs nonshivering patients. (2) To describe temperatures, hemodynamics, therapeutics, myocardial oxygen consumption correlates (rate-pressure product, heart rate, systemic vascular resistance) in shivering and nonshivering groups, and shivering and nonshivering periods. (3) To characterize the electromyogram to determine whether the tremor is cold-induced. METHODS: A descriptive design with a time series component was used to study a convenience sample of 10 shivering and 10 nonshivering adults for 4 hours during early recovery from cardiac surgery. Pulmonary artery and skin (facial, calf, trunk) temperature were measured every 60 seconds; heart rate and arterial pressure, every 15 minutes; cardiac output, 3 times. Electromyogram was recorded intermittently. Medications and treatments were noted. RESULTS: Lower skin temperature was significantly related to shivering risk. Heart rate was significantly higher initially in shiverers and remained higher by 13.6 beats per minute. Significantly more nitroprusside was used to control arterial pressure before than after shivering. No significant differences were noted between groups in core temperature, age, weight, body surface area, anesthesia type, intraoperative temperature; or surgery, circulatory bypass, or cardiac cross-clamp duration. The electromyogram pattern during shivering was typical of that produced by cold. CONCLUSIONS: These results suggest that true shivering occurs after cardiac surgery. Skin, but not core, temperature and elevated heart rate predict shivering. Shivering may be more likely in hemodynamically unstable patients.

scholarly journals Contrast Volume for Preoperative CT Angiography of the Aorta Based on Patient Heart Rate and Body Surface Area: A Pilot Study

2019 ◽  
Vol 103 (1) ◽  
Author(s):  
Dominic Raymakers ◽  
Adriana Dubbeldam ◽  
Walter Coudyzer ◽  
Hilde Bosmans ◽  
Geert Maleux
Keyword(s):  
Heart Rate ◽  
Pilot Study ◽  
Surface Area ◽  
Body Surface Area ◽  
Ct Angiography ◽  
Body Surface ◽  
Contrast Volume ◽  
Preoperative Ct

Natural course of supravalvar aortic stenosis and peripheral pulmonary arterial stenosis in Williams‘ syndrome

1999 ◽  
Vol 9 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Yang Min Kim ◽  
Shi-Joon Yoo ◽  
Jung Yun Choi ◽  
Seong Ho Kim ◽  
Eun Jung Bae ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Right Ventricular ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Systolic Pressure ◽  
Arterial Stenosis ◽  
Right Ventricular Systolic Pressure ◽  
Pulmonary Arterial ◽  
Pulmonary Arterial Stenosis

AbstractWe investigated the catheterization and angiographic findings of 26 patients with Williams‘ syndrome to evaluate the natural course of supravalvar aortic stenosis and peripheral pulmonary arterial stenosis. The severity of the stenosis was correlated with age and body surface area in terms of the pulmonary arterial index, right ventricular systolic pressure, sinutubular ratio(ratio of measured to mean normal diameter of sinutubular junction), and systolic pressure gradient across the sinutubular junction. In patients with pulmonary arterial stenosis (n=20), right ventricular systolic pressure tended to decrease, and pulmonary arterial index increased, with increase in age and body surface area. Between the groups with and without pulmonary arterial stenosis, there was significant difference in age (mean 4.70 vs. 9.87, p = 0.019), body surface area (0.62 vs. 1.16, p = 0.002), pulmonary arterial index (152 vs. 317, p=0.002) and right ventricular systolic pressure (73.9 vs. 33.0, p=0.006). As all patients showed similar diameters at the sinutubular junction regardless of age and body size, sinutubular ratio decreased with increases in age and body surface area. The group with abnormal coronary arteries (n = 7) had smaller sinutubular ratio (0.46 vs. 0.61, p=0.021) and higher pressure gradients between the left ventricle and the aorta (67.6 vs. 42.2, p=0.023) than did the group with normal coronary arteries. Stenosis of a coronary artery, or a branch of the aortic arch, was observed only in three patients with diffuse aortic stenosis.Our results suggest that, with time, peripheral pulmonary arterial stenosis tends to improve, and supravalvar aortic stenosis to progress. Failure of growth of the sinutubular junction might be responsible for the progression of the aortic lesion. Progression of the aortic lesion may be associated with involvement of the coronary arteries.

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