scholarly journals Left ventricular–right ventricular interaction in paediatric idiopathic dilated cardiomyopathy

2013 ◽  
Vol 23 (4) ◽  
pp. 626-626
Author(s):  
Martin Koestenberger ◽  
William Ravekes
Keyword(s):  
Right Ventricular ◽  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Ventricular Interaction

The role of right ventricular function in paediatric idiopathic dilated cardiomyopathy

2012 ◽  
Vol 23 (3) ◽  
pp. 409-415 ◽  
Author(s):  
Abraham Groner ◽  
Jen Yau ◽  
Irene D. Lytrivi ◽  
H. Helen Ko ◽  
James C. Nielsen ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Dilated Cardiomyopathy ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Left Ventricular Ejection ◽  
P Value

AbstractIntroductionThe prevalence of right ventricular dysfunction in idiopathic dilated cardiomyopathy is incompletely studied in children. Furthermore, right ventricular function may signal worse outcomes. We evaluated recently published right ventricular function echocardiographic indices in identifying dysfunction in children with idiopathic dilated cardiomyopathy and the impact of right ventricular dysfunction on long-term prognosis.MethodsA retrospective database review of right ventricular function indices in 30 patients with idiopathic dilated cardiomyopathy was compared with 60 age- and sex-matched controls from January, 2001 until December, 2010. Right ventricular function was assessed by Doppler tissue peak systolic S′, early and late diastolic E′ and A′ waves and isovolumic acceleration at the tricuspid valve annulus; pulsed wave Doppler tricuspid valve inflow E and A waves; right ventricular myocardial performance index; tricuspid annular plane systolic excursion; right ventricular fractional area change.ResultsRight ventricular systolic and diastolic function in idiopathic dilated cardiomyopathy was significantly impaired. All measured indices except for isovolumic acceleration and fractional area change were significantly reduced, with a p-value less than 0.05. There was no right ventricular index predictive of death or transplantation. Patients with poor outcome were significantly more likely to need inotropic support (p-value equal to 0.018), be placed on a ventricular assist device (p equal to 0.005), and have a worse left ventricular ejection fraction z-score (p-value equal to 0.002).ConclusionRight ventricular dysfunction is under-recognised in children presenting with idiopathic dilated cardiomyopathy. The need for clinical circulatory support and left ventricular ejection fraction z-score less than minus 8 were primary determinants of outcome, independent of the degree of derangement in right ventricular function.

Left-to-right systolic ventricular interaction in patients undergoing biventricular stimulation for dilated cardiomyopathy

2010 ◽  
Vol 109 (2) ◽  
pp. 418-423 ◽  
Author(s):  
Giuseppe Osculati ◽  
Gabriella Malfatto ◽  
Roberto Chianca ◽  
Giovanni B. Perego
Keyword(s):  
Right Ventricular ◽  
Dilated Cardiomyopathy ◽  
Biventricular Pacing ◽  
Interventricular Septum ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Data Set ◽  
Ventricular Interaction ◽  
Left And Right ◽  
The Right

Left-to-right systolic ventricular interaction (i.e., the phenomenon by which the left ventricle contributes to most of the flow and to two-thirds of the pressure generated by the right ventricle) originates from transmission of systolic forces between the ventricles through the interventricular septum and from the mechanical effect of the common muscle fibers encircling their free walls. As a consequence, any reduction of left ventricular free wall function translates in lower right ventricular pressure or function. We investigated whether systolic ventricular interaction could be evidenced in nine patients with dilated cardiomyopathy in whom a biventricular pacemaker was implanted. Changes in right and left ventricular pressures were measured with high-fidelity catheters, before and after periods of biventricular pacing from the right atrium with different stimulation intervals to the right and left ventricles, respectively. The steady-state changes of left and right ventricular systolic pressure obtained from any single pacing interval combination were considered. We then calculated, with a two-level mixed regression analysis of the entire data set, the relation between changes in left and right systolic pressures: the presence of a statistically significant slope was assumed as evidence of ventricular interaction. The slope of the regression replaced the crude pressure ratio as an estimate of the gain of the interaction; its value compared with values observed in experimental studies. Moreover, its dependence on septal elastance and on right ventricular volume was similar to that already demonstrated for ventricular interaction gain. In conclusion, the linear relationship we found between systolic pressure changes in the two ventricles of patients with dilated cardiomyopathy during biventricular pacing could be explained in terms of ventricular interaction.

scholarly journals Vitamin D Status in Children with Idiopathic Dilated Cardiomyopathy

2021 ◽  
Vol 11 (01) ◽  
pp. e120-e124
Author(s):  
Duaa M. Raafat ◽  
Osama M. EL-Asheer ◽  
Amal A. Mahmoud ◽  
Manal M. Darwish ◽  
Naglaa S. Osman
Keyword(s):  
Vitamin D ◽  
Serum Level ◽  
Dilated Cardiomyopathy ◽  
Smooth Muscles ◽  
Left Ventricular ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Vitamin D Receptors ◽  
Left Ventricular Dimensions ◽  
And Function ◽  
Ventricular Dimensions

AbstractDilated cardiomyopathy (DCM) is the third leading cause of heart failure in pediatrics. The exact etiology of DCM is unknown in more than half of the cases. Vitamin D receptors are represented in cardiac muscles, endothelium, and smooth muscles of blood vessels suggesting that vitamin D could have a vital cardioprotective function. This study aimed to assess serum level of vitamin D in children with idiopathic DCM and to correlate the serum level of vitamin D with the left ventricular dimensions and function. This study is a descriptive cross-sectional single-center study, includes 44 children of both sexes, diagnosed as idiopathic DCM. Serum level of vitamin D was assessed and correlated with the left ventricular dimensions and function. Mean age of studied children was 6.08 ± 4.4 years. Vitamin D deficiency was found in 90.9% of children with idiopathic DCM with a mean level 13.48 ng/mL. There was a negative correlation between vitamin D level and fraction shortening and left ventricular end-diastolic diameter in children with DCM. Vitamin D level is not only significantly low in children with idiopathic DCM but it is also significantly correlated with the degree of left ventricular dysfunction.

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