Abstract 13502: Impact of Udenafil on Echocardiographic Indices of Single Ventricle Size and Function in Fuel Study Participants

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Michael V Di Maria ◽  
David J Goldberg ◽  
Stephen Paridon ◽  
Adam Lubert ◽  
Andreea Dragulescu ◽  
...  
Keyword(s):  
Single Ventricle ◽  
Venous Return ◽  
Systolic Function ◽  
Atrioventricular Valve ◽  
Global Function ◽  
Ventricular Relaxation ◽  
And Function ◽  
Ventricle Size ◽  
Study Participants ◽  
Fontan Fenestration

Introduction: The Pediatric Heart Network’s Fontan Udenafil Exercise Longitudinal (FUEL) Trial (Mezzion Pharma Co. Ltd., NCT 02741115) demonstrated improvements in exercise capacity following 6 months of treatment with udenafil (87.5 mg po BID). The effect of udenafil on echocardiographic measures of single ventricle (SV) function in this cohort has not been studied. Methods: Protocol echocardiograms were obtained at baseline and 26 weeks after initiation of udenafil/placebo. Linear regression compared change from baseline in indices of SV systolic, diastolic and global function, atrioventricular valve (AVV) regurgitation and mean Fontan fenestration gradient in the udenafil cohort vs placebo, controlling for ventricular morphology (LV vs. RV/other). Effects of ventricular morphology on echo measures and its interaction over time was also evaluated. Difficult imaging windows limited consistent capture of all measures. Results: The 191 udenafil participants had significantly improved myocardial performance index (p=0.03), AVV inflow peak E and A velocities (p = 0.007 and 0.03), and annular DTI-derived peak e’ velocity (p = 0.008) compared to 195 placebo participants (Table). There were no significant differences in change in SV size, systolic function, AVV regurgitation severity or mean fenestration gradient. Although LV morphology participants had significantly more favorable indices of SV size and function (lower volumes and areas, E/e’ ratio, systolic:diastolic time and AVV regurgitation, and higher annular s’ and e’ velocity) at baseline, there was no differential effect of udenafil by ventricular morphology at 26 weeks. Conclusions: FUEL participants who received udenafil demonstrated a significant improvement in global and diastolic echo indices. The changes in diastolic function suggest improvement in pulmonary venous return and/or augmented ventricular relaxation, which may help explain improved exercise performance in that cohort.

Left ventricular non-compaction in patients with single ventricle heart disease

2020 ◽  
Vol 30 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Preeti Choudhary ◽  
Wendy Strugnell ◽  
Rajesh Puranik ◽  
Christian Hamilton-Craig ◽  
Shelby Kutty ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ventricular Function ◽  
Single Ventricle ◽  
Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Left Ventricular Volumes ◽  
Ventricular Ejection Fraction ◽  
Ventricular Volumes ◽  
And Function

AbstractObjective:Left ventricular non-compaction is an architectural abnormality of the myocardium, associated with heart failure, systemic thromboembolism, and arrhythmia. We sought to assess the prevalence of left ventricular non-compaction in patients with single ventricle heart disease and its effects on ventricular function.Methods:Cardiac MRI of 93 patients with single ventricle heart disease (mean age 24 ± 8 years; 55% male) from three tertiary congenital centres was retrospectively reviewed; 65 of these had left ventricular morphology and are the subject of this report. The presence of left ventricular non-compaction was defined as having a non-compacted:compacted (NC:C) myocardial thickness ratio >2.3:1. The distribution of left ventricular non-compaction, ventricular volumes, and function was correlated with clinical data.Results:The prevalence of left ventricular non-compaction was 37% (24 of 65 patients) with a mean of 4 ± 2 affected segments. The distribution was apical in 100%, mid-ventricular in 29%, and basal in 17% of patients. Patients with left ventricular non-compaction had significantly higher end-diastolic (128 ± 44 versus 104 ± 46 mL/m2, p = 0.047) and end-systolic left ventricular volumes (74 ± 35 versus 56 ± 35 mL/m2, p = 0.039) with lower left ventricular ejection fraction (44 ± 11 versus 50 ± 9%, p = 0.039) compared to those with normal compaction. The number of segments involved did not correlate with ventricular function (p = 0.71).Conclusions:Left ventricular non-compaction is frequently observed in patients with left ventricle-type univentricular hearts, with predominantly apical and mid-ventricular involvement. The presence of non-compaction is associated with increased indexed end-diastolic volumes and impaired systolic function.

Effects of avertin versus xylazine-ketamine anesthesia on cardiac function in normal mice

2001 ◽  
Vol 281 (5) ◽  
pp. H1938-H1945 ◽  
Author(s):  
Chari Y. T. Hart ◽  
John C. Burnett ◽  
Margaret M. Redfield
Keyword(s):  
Cardiac Function ◽  
Diastolic Pressure ◽  
Systolic Function ◽  
Pressure Rise ◽  
Left Ventricular ◽  
Lv Function ◽  
Ketamine Anesthesia ◽  
The Difference ◽  
And Function ◽  
Derivatives Of

Anesthetic regimens commonly administered during studies that assess cardiac structure and function in mice are xylazine-ketamine (XK) and avertin (AV). While it is known that XK anesthesia produces more bradycardia in the mouse, the effects of XK and AV on cardiac function have not been compared. We anesthetized normal adult male Swiss Webster mice with XK or AV. Transthoracic echocardiography and closed-chest cardiac catheterization were performed to assess heart rate (HR), left ventricular (LV) dimensions at end diastole and end systole (LVDd and LVDs, respectively), fractional shortening (FS), LV end-diastolic pressure (LVEDP), the time constant of isovolumic relaxation (τ), and the first derivatives of LV pressure rise and fall (dP/d t max and dP/d t min, respectively). During echocardiography, HR was lower in XK than AV mice (250 ± 14 beats/min in XK vs. 453 ± 24 beats/min in AV, P < 0.05). Preload was increased in XK mice (LVDd: 4.1 ± 0.08 mm in XK vs. 3.8 ± 0.09 mm in AV, P < 0.05). FS, a load-dependent index of systolic function, was increased in XK mice (45 ± 1.2% in XK vs. 40 ± 0.8% in AV, P < 0.05). At LV catheterization, the difference in HR with AV (453 ± 24 beats/min) and XK (342 ± 30 beats/min, P < 0.05) anesthesia was more variable, and no significant differences in systolic or diastolic function were seen in the group as a whole. However, in XK mice with HR <300 beats/min, LVEDP was increased (28 ± 5 vs. 6.2 ± 2 mmHg in mice with HR >300 beats/min, P < 0.05), whereas systolic (LV dP/d t max: 4,402 ± 798 vs. 8,250 ± 415 mmHg/s in mice with HR >300 beats/min, P < 0.05) and diastolic (τ: 23 ± 2 vs. 14 ± 1 ms in mice with HR >300 beats/min, P < 0.05) function were impaired. Compared with AV, XK produces profound bradycardia with effects on loading conditions and ventricular function. The disparate findings at echocardiography and LV catheterization underscore the importance of comprehensive assessment of LV function in the mouse.

Noun modifiers and the n preposition in Siwi Berber (Egypt)

2020 ◽  
Vol 41 (2) ◽  
pp. 239-263
Author(s):  
Valentina Schiattarella
Keyword(s):  
Relative Clause ◽  
Head Noun ◽  
Supplementary Data ◽  
Global Function ◽  
Possessive Constructions ◽  
And Function

Abstract The three most common strategies used to modify a head noun, namely through a possessive, an adjective and a relative clause construction feature in Siwi the use of the preposition n. Its presence is obligatory in the possessive constructions, but only present before an adjective or a relative clause in some contexts, depending on the level of restriction that the speaker wants to place on the head noun. The aim of the article is to describe the use and function of n in all three contexts of noun modification in Siwi and present supplementary data that helps the understanding of the global function of this preposition.

STRUCTURALAND FUNCTIONAL CHANGES OF HEART IN DEPENDENCE OF GALLBLADDER CONDITION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

2020 ◽  
Vol 86 (1) ◽  
pp. 16-20
Author(s):  
L. M. Strilchuk
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Functional Changes ◽  
Pathological Conditions ◽  
Optimal Values ◽  
And Function

According to the literature data, gallbladder (GB) condition influences the course of coronary heart disease (CHD) and parameters of heart structure and function. The aim of this work was to estimate the peculiarities of heart condition in patients with CHD (acute myocardial infarction) in dependence of GB condition. We held a retrospective analysis of data of 142 patients. Results. It was revealed that in 83.7 % patients GB was changed: cholelithiasis (34.5 %), past cholecystectomy due to cholelithiasis (7.0 %), sludge and poliposis (17.6 %), bent GB body (13.4 %), neck deformations and signs of past cholecystitis (14.8 %). GB changes were accompanied by significant increase of heart rate, which was the most prominent in case of cholelithiasis, neck deformations and past cholecystitis signs. Conclusions. Pathological conditions of GB were accompanied by left ventricle dilatation, aortic distension, significant decrease of ejection fraction and systolic dysfunction, whereas after GB removal sizes of heart chambers were close to optimal values, although the systolic function did not normalize. Keywords: gallbladder, coronary heart disease, sludge, cholecystitis, heart structure.

Surgery of the left atrioventricular valve and of the left ventricular outflow tract in atrioventricular septal defect

1991 ◽  
Vol 1 (4) ◽  
pp. 344-355 ◽  
Author(s):  
Tjark Ebles
Keyword(s):  
Septal Defect ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Atrioventricular Septal Defect ◽  
Left Ventricular ◽  
Atrioventricular Valve ◽  
Left Ventricular Outflow ◽  
Cardiac Surgeon ◽  
The Individual ◽  
And Function

SummaryMalfunctioning of the left atrioventricular valve has always been, and remains, the major incremental risk factor in the repair of atrioventricular septal defect. Now that the cardiac surgeon has ample time to assess the anatomy and function of the left valve, results have improved, but are still less than ideal. On the presumption that the anterior leaflet of the mitral valve is “cleft” in this anomaly, it used to be common practice to close the “cleft”. Currently, a substantial number of surgeons employ this technique, often irrespective of the individual anatomy, and in the majority of cases with success.

scholarly journals Mid-term result of atrioventricular valve replacement in patients with a single ventricle†

2018 ◽  
Vol 27 (6) ◽  
pp. 895-900 ◽  
Author(s):  
Koichi Sughimoto ◽  
Yasutaka Hirata ◽  
Norimichi Hirahara ◽  
Hiroaki Miyata ◽  
Takaaki Suzuki ◽  
...  
Keyword(s):  
Valve Replacement ◽  
Single Ventricle ◽  
Atrioventricular Valve ◽  
Term Result

Abstract 17543: The Chicken or the Eggs? Examining the Causal Relationship Between the Development of Atrioventricular Valve Regurgitation and Ventricular Dysfunction in Patients With Functionally Single-Ventricle Physiology

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yasuhiro Kotani ◽  
Devin Chetan ◽  
Selvi Senthilnathan ◽  
Arezou Saedi ◽  
Christopher A Caldarone ◽  
...  
Keyword(s):  
Causal Relationship ◽  
Single Ventricle ◽  
Ventricular Dysfunction ◽  
Stage I ◽  
Stage Ii ◽  
Atrioventricular Valve ◽  
Valve Regurgitation ◽  
Ventricular Dilation ◽  
Atrioventricular Valve Regurgitation ◽  
Annular Dilation

Introduction: Development of atrioventricular valve regurgitation (AVVR) with or without ventricular dysfunction (VD) often occurs during the first 6 months of life and has a significant impact on outcomes for single-ventricle patients. Yet, it is not well known whether AVVR causes VD or vice versa. Thus, we sought to identify the timing and causal relationship between AVVR and VD. Methods: Among 156 consecutive single-ventricle patients who had staged palliation (2005- 2012), 28 who had AVV repair at the time of stage II (n=24, 86%) or inter-stage (n=4, 14%) were reviewed. Diagnosis included HLHS in 17 (61%) patients, tricuspid atresia in 2 (7%), and others in 9 (32%). Ventricular morphology was left-dominant in 6 (21%) patients and right-dominant in 22 (79%). AVV morphology included mitral in 6 (21%) patients, tricuspid in 18 (64%), and common in 4 (14%). Serial echocardiograms were reviewed to identify the timing of development of AVVR and/or VD. Results: After stage I palliation, ventricular end-diastolic dimension (VEDD) z-score significantly increased from 4.01 to 5.69 (p<0.01) AVVR (Figure). By the time of stage II palliation, VEDD further increased and subsequent AVV annular dilation occurred, resulting in 23 patients with significant AVVR. None of the patients, however, had significant VD before stage II palliation/AVV repair, but 9 patients developed significant VD after AVV repair. Conclusions: Ventricular dilation occurred immediately after stage I palliation and continued until stage II palliation. Secondary annular dilation occurred inter-stage and this further triggered the development of AVVR. Tangible ventricular dysfunction was not seen before AVV repair, however, important ventricular dysfunction was unmasked after volume unloading surgery. Heart failure management and early intervention to significant AVVR may reduce the incidence of ventricular dysfunction following AVV repair.

Sign in / Sign up

Export Citation Format

Share Document