Abstract 16138: Chest and Cardiac Compression on CT/MRI and on TEE Predicts Improvement in Right Heart Chamber Size and Right Ventricular Deformation Post Pectus Excavatum Repair Surgery

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Chieh-Ju Chao ◽  
Michael B Gotway ◽  
Dawn E Jaroszewski ◽  
Steven Lester ◽  
Samuel Unzek ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Pectus Excavatum ◽  
Global Longitudinal Strain ◽  
Right Atrial ◽  
Right Heart ◽  
Cardiac Chamber ◽  
Heart Chamber ◽  
Cardiac Compression ◽  
2D Strain ◽  
Chamber Size

Background: Pectus excavatum (PE) deformity involves posterior depression of the sternum and adjacent costal cartilages. The relationship of CT/MRI chest cardiac compression indices used as indications for surgical repair of PE with echocardiographic findings and with improvement in cardiac chamber compression and function post PE repair is unknown. Methods: We evaluated right atrial (RA) size, tricuspid annulus (TA size, right ventricular (RV) outflow tract size as well as RV 2D strain on intra-operative trans-esophageal echocardiography (TEE) immediately pre and post surgical PE repair. Inspiratory and expiratory Haller Index (HI) and cardiac compression indices (CCI) were measured on pre op CT/MR scans (Figure). Offline measurement of chamber dimensions on TEE images was performed and Speckle tracking strain measurements were made using Syngo US Workplace software (Siemens). P<0.05 was considered significant. Results: 60 patients, 73% male, 27% female, age 33.6±10.3 yrs underwent PE repair following CT/MRI from 2010-2014 (Figure). There was a strong correlation between expiratory CT/MRI chest AP diameter and pre-op RA size (panel A). Pre op RA and TA compression on TEE inversely correlated with pre op RV global longitudinal strain rate(RVGLSR) (panels B & C). CCI predicted improvement in RA size post PE repair (panels D & E). In addition pre op RA size on TEE correlated with improvement in RVGLSR post PE repair surgery (panel F). Conclusion: In patients with PE deformity, pre surgical CCI correlated with right-sided cardiac chamber compression on pre op TEE. Severity of chest and cardiac compression also predicted magnitude of improvement in right-sided chamber size and RV longitudinal deformation post PE repair. Our findings provide insight regarding the beneficial effects of PE surgery on right heart chamber compression and improvement in RV function and the important role of intraoperative TEE for patients undergoing PE repair surgery.

Mild regurgitation of the mitral and aortic valve with normal right heart chamber size

ASVIDE ◽  
2021 ◽  
Vol 8 ◽  
pp. 005-005
Author(s):  
Thai Truong ◽  
Hang Thi Tuyet Nguyen ◽  
Vien Thi Xuan Phan ◽  
Minh Huong Phu Ly ◽  
Van Thi Tuong Phan ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Right Heart ◽  
Heart Chamber ◽  
Chamber Size

scholarly journals Moderated Posters: Imaging of the right heart - What is new?P814Prognostic value of parameters of pulmonary artery stiffness in patients with pulmonary hypertension receiving specific vasodilator therapyP815Reconsidering of inferior vena cava parameters for estimating right atrial pressure: a comparative simultaneous ultrasound-catheterization studyP816Pulmonary hypertension is the main factor echocardiography to predicting mortality in medium and long term in a cohort of patients with heart failureP817Normal values for 3D-right atrial volumes : results from the SKIPOGH-II population studyP818Assessment of right ventricular function by free wall longitudinal strain in organic mitral regurgitationP819Importance of radial dysfunction to determine the impairment of right ventricular ejection fraction in patients with pulmonary hypertensionP820Influence of tricuspid regurgitation severity on non-invasive assessment of right heart hemodynamics: a simultaneous echocardiography-catheterization studyP821Right ventricular failure following ventricular assist device implant: systematic review and meta-analysis of clinical and echocardiographic predictors

2016 ◽  
Vol 17 (suppl 2) ◽  
pp. ii161-ii163
Author(s):  
R. Enache ◽  
N. Sawada ◽  
L. Molina Ferragut ◽  
P. Monney ◽  
A. Jobbe Duval ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Meta Analysis ◽  
Vena Cava ◽  
Right Ventricular Ejection Fraction ◽  
Right Atrial ◽  
Right Heart ◽  
Ventricular Assist ◽  
Ventricular Ejection Fraction ◽  
Artery Stiffness ◽  
The Right

scholarly journals Research progress in the effects of pectus excavatum on cardiac functions

2020 ◽  
Vol 3 (2) ◽  
pp. e000142
Author(s):  
Caixia Liu ◽  
Yunhong Wen
Keyword(s):  
Cardiac Function ◽  
Chest Wall ◽  
Pectus Excavatum ◽  
Myocardial Strain ◽  
Clinical Work ◽  
Right Atrial ◽  
Research Progress ◽  
Cardiac Compression ◽  
Cardiac Functions ◽  
Negative Effect

BackgroundPectus excavatum, the most common chest wall deformity in children, accounts for nearly 90% of congenital malformations of chest wall. Initially, both parents and doctors paid more attention to the influence of this deformity on patient appearance and psychology. Following deeper studies of pectus excavatum, researchers found that it also affected cardiac functions. The purpose of this review aims to present recent research progress in the effects of pectus excavatum on cardiac functions.Data sourcesBased on aspects of CT, ultrasound cardiography (UCG) and MRI, all the recent literatures on the influence of pectus excavatum on cardiac function were searched and reviewed.ResultsModerate and severe pectus excavatum did have a negative effect on cardiac function. Cardiac rotation angle, cardiac compression index, right atrial and tricuspid annulus size, septal motion and myocardial strain are relatively effective indexes to evaluate cardiac function.ConclusionsPectus excavatum did have a negative effect on cardiac function; so surgeons should actively diagnose and treat such patients in clinical work. However, further research is needed on to explore the measures and indicators that can reflect the changes of cardiac function in patients objectively, accurately, effectively and timely.

Surgical repair of pectus excavatum relieves right heart chamber compression and improves cardiac output in adult patients—an intraoperative transesophageal echocardiographic study

2015 ◽  
Vol 210 (6) ◽  
pp. 1118-1125 ◽  
Author(s):  
Chieh-Ju Chao ◽  
Dawn E. Jaroszewski ◽  
Preetham N. Kumar ◽  
MennatAllah M. Ewais ◽  
Christopher P. Appleton ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Pectus Excavatum ◽  
Surgical Repair ◽  
Adult Patients ◽  
Right Heart ◽  
Heart Chamber ◽  
Echocardiographic Study

scholarly journals Genetic Analysis of Right Heart Structure and Function in 40,000 People

2021 ◽  
Author(s):  
James P. Pirruccello ◽  
Paolo Di Achille ◽  
Victor Nauffal ◽  
Mahan Nekoui ◽  
Samuel N. Friedman ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Deep Learning ◽  
Right Ventricular ◽  
Congenital Heart ◽  
Left Ventricular ◽  
Structure And Function ◽  
Right Heart ◽  
Heart Chamber ◽  
The Right ◽  
And Function

The heart evolved hundreds of millions of years ago. During mammalian evolution, the cardiovascular system developed with complete separation between pulmonary and systemic circulations incorporated into a single pump with chambers dedicated to each circulation. A lower pressure right heart chamber supplies deoxygenated blood to the lungs, while a high pressure left heart chamber supplies oxygenated blood to the rest of the body. Due to the complexity of morphogenic cardiac looping and septation required to form these two chambers, congenital heart diseases often involve maldevelopment of the evolutionarily recent right heart chamber. Additionally, some diseases predominantly affect structures of the right heart, including arrhythmogenic right ventricular cardiomyopathy (ARVC) and pulmonary hypertension. To gain insight into right heart structure and function, we fine-tuned deep learning models to recognize the right atrium, the right ventricle, and the pulmonary artery, and then used those models to measure right heart structures in over 40,000 individuals from the UK Biobank with magnetic resonance imaging. We found associations between these measurements and clinical disease including pulmonary hypertension and dilated cardiomyopathy. We then conducted genome-wide association studies, identifying 104 distinct loci associated with at least one right heart measurement. Several of these loci were found near genes previously linked with congenital heart disease, such as NKX2-5, TBX3, WNT9B, and GATA4. We also observed interesting commonalities and differences in association patterns at genetic loci linked with both right and left ventricular measurements. Finally, we found that a polygenic predictor of right ventricular end systolic volume was associated with incident dilated cardiomyopathy (HR 1.28 per standard deviation; P = 2.4E-10), and remained a significant predictor of disease even after accounting for a left ventricular polygenic score. Harnessing deep learning to perform large-scale cardiac phenotyping, our results yield insights into the genetic and clinical determinants of right heart structure and function.

Cardiopulmonary Function in Thoracic Wall Deformities: What Do We Really Know?

2018 ◽  
Vol 28 (04) ◽  
pp. 327-346 ◽  
Author(s):  
Cristine Velazco ◽  
Venkata Pulivarthi ◽  
Reza Arsanjani ◽  
Robert Obermeyer ◽  
Dawn Jaroszewski
Keyword(s):  
Strain Rate ◽  
Pectus Excavatum ◽  
Surgical Repair ◽  
Exercise Intolerance ◽  
Thoracic Wall ◽  
Cardiac Chamber ◽  
Chest Wall Mechanics ◽  
Strain And Strain Rate ◽  
Cardiac Strain ◽  
Chamber Size

AbstractPatients with pectus excavatum (PE) frequently present with complaints of exercise intolerance and cardiopulmonary symptoms. There continues to be controversy regarding the physiologic benefits of repair. The aim of this review is to summarize and discuss recent data regarding the cardiopulmonary effects of PE deformity and the evidence for improvement obtained after surgical repair including (1) a greater efficiency of breathing (chest wall mechanics), (2) improvement in pulmonary restrictive deficits, (3) an increase in cardiac chamber size and output, with improved cardiac strain and strain rate, and (4) improvement in exercise capacity.

Afferent sympathetic nerve fibers with mechanoreceptors in the right heart

1975 ◽  
Vol 228 (1) ◽  
pp. 223-230 ◽  
Author(s):  
Y Uchida
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricular ◽  
Sympathetic Nerve ◽  
Nerve Fibers ◽  
Right Atrial ◽  
Right Heart ◽  
Unmyelinated Fibers ◽  
Myelinated Fibers ◽  
Sympathetic Nerve Fibers ◽  
The Right

Mechanosensitivity of afferent sympathetic nerve fibers from the right heart and the pulmonary artery has been examined. Action potentials of the afferent fibers that responded to tapping the right heart and the pulmonary artery were derived from upper thoracic communicating rami of both sides of anesthetized dogs. The fibers were composed of myelinated Adelta fibers and unmyelinated fibers. The receptive fields of both groups of fibers were located widely in the right heart and the pulmonary artery. Myelinated fibers ceased to fire quickly whereas unmyelinated fibers continued to fire after withdrawl of a brief mechanical stimulus. In the myelinated group, the pressure threshold was 3-50, 6-58, and 3-10 mmHg for right ventricular, pulmonary and right atrial threshold was 15-58, 22-34, and 4-8 mmHg for right ventricular, pulmonary, and right atrial fibers, respectively. Spontaneous discharge of myelinated fibers was synchronous with each rise and/or fall in intracardiac or pulmonary pressure whereas that of unmyelinated fibers was irregular and independent. A rise in pressure produced by pulmonary embolization or occlusion caused an augumented discharge whereas a fall caused by caval vein occulsion eliminated the discharge. The results indicate the existence of both myelinated and unmyelinated fibers with mechanoreceptors in the right heart and the pulmonary artery.

scholarly journals Sleep disordered breathing and enlargement of the right heart after myocardial infarction

2014 ◽  
Vol 45 (3) ◽  
pp. 680-690 ◽  
Author(s):  
Stefan Buchner ◽  
Michael Eglseer ◽  
Kurt Debl ◽  
Andrea Hetzenecker ◽  
Andreas Luchner ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Sleep Disordered Breathing ◽  
Left Ventricular ◽  
Right Atrial ◽  
Right Heart ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume ◽  
The Right

Structural and functional integrity of the right heart is important in the prognosis after acute myocardial infarction (AMI). The objective of this study was to assess the impact of sleep disordered breathing (SDB) on structure and function of the right heart early after AMI.54 patients underwent cardiovascular magnetic resonance 3–5 days and 12 weeks after AMI, and were stratified according to the presence of SDB, defined as an apnoea–hypopnoea index of ≥15 events·h−1.12 weeks after AMI, end-diastolic volume of the right ventricle had increased significantly in patients with SDB (n=27)versusthose without (n=25) (mean±sd14±23%versus0±17%, p=0.020). Multivariable linear regression analysis accounting for age, sex, body mass index, smoking, left ventricular mass and left ventricular end-systolic volume showed that the apnoea–hypopnoea index was significantly associated with right ventricular end-diastolic volume (B-coefficient 0.315 (95% CI 0.013–0.617); p=0.041). From baseline to 12 weeks, right atrial diastolic area increased more in patients with SDB (2.9±3.7 cm2versus1.0±2.4 cm2, p=0.038; when adjusted for left ventricular end systolic volume, p=0.166).SDB diagnosed shortly after AMI predicts an increase of right ventricular end-diastolic volume and possibly right atrial area within the following 12 weeks. Thus, SDB may contribute to enlargement of the right heart after AMI.

Sympathetic afferent nerve activity of right heart origin

1975 ◽  
Vol 229 (4) ◽  
pp. 911-915 ◽  
Author(s):  
DR Kostreva ◽  
EJ Zuperku ◽  
RV Purtock ◽  
RL Coon ◽  
JP Kampine
Keyword(s):  
Right Ventricular ◽  
Nerve Fibers ◽  
Maximum Activity ◽  
Right Atrial ◽  
Sodium Pentobarbital ◽  
Nerve Activity ◽  
Right Heart ◽  
Average Maximum ◽  
The Right ◽  
Upper Thoracic

Six mongrel dogs anesthetized with sodium pentobarbital and paralyzed with gallamine triethiodide were studied on total cardiopulmonary bypass. This study verified the existence of right heart mechanoreceptors whose afferent nerves traverse the upper thoracic white rami communicantes. these mechanoreceptors were studied by observing changes in average maximum, and total nerve spike frequency when right atrial and right ventricular systolic and diastolic pressures were altered by means of intracardiac balloons. Receptors that responded to volume and pressure changes were found in both the right atrium and right ventricle. Nerve activity in these afferents increased with increasing right atrial and right ventricular pressures. These mechanoreceptors were more responsive in the upper physiological ranges of right heart pressures. In most nerve fibers studied, maximum activity occurred during both right atrial and right ventricular diastole.

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