TY - JOUR
T1 - Early changes in right ventricular function and their clinical consequences in childhood and adolescent dilated cardiomyopathy
AU - Grosse-Wortmann, Lars
AU - Roche, Susan L.
AU - Yoo, Shi Joon
AU - Seed, Mike
AU - Kantor, Paul
N1 - Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2010/8
Y1 - 2010/8
N2 - The aim of the paper was to investigate the right ventricle in paediatric dilated cardiomyopathy. We examined 11 patients with dilated cardiomyopathy as well as 12 normal paediatric controls. Cardiac magnetic resonance imaging was performed for ventricular size and function. N-terminal pro-brain natriuretic peptide was collected at this time and the results from the most recent echocardiogram and exercise test were reviewed. We found that patients with dilated cardiomyopathy had significantly faster heart rates, that is, 85 versus 65 beats per minute, lower left ventricular ejection fraction, that is, 42 versus 61%, and right ventricular ejection fraction of 44 versus 54%, lower left and right ventricular stroke volumes, that is, 35.5 versus 49.5 millilitres per square metre and 40.9 versus 56.4 millilitres per square metre, respectively, and lower mitral and tricuspid valve inflow e/a wave velocity ratios of 2.02 versus 2.80 and 1.25 versus 2.58, respectively, than the controls. Tricuspid valve annulus velocity, measured by tissue Doppler echocardiography, correlated with right ventricular ejection fraction (r = 0.60, p = 0.05). Right ventricular ejection fraction and indexed right ventricular end-diastolic volume correlated with N-terminal pro-brain natriuretic peptide (r = 0.67, p = 0.03, r = 0.65, p = 0.04, respectively), and right ventricular ejection fraction correlated with the oxygen uptake at the anaerobic threshold (r = 0.67, p = 0.049). Neither left ventricular ejection fraction nor left ventricular volume correlated with N-terminal pro-brain natriuretic peptide or exercise tolerance. The right ventricular function is decreased in the early stages of dilated cardiomyopathy. Right ventricular size and ejection fraction may be important indicators of sub-clinical cardiac failure and we suggest monitoring them routinely in dilated cardiomyopathy.
AB - The aim of the paper was to investigate the right ventricle in paediatric dilated cardiomyopathy. We examined 11 patients with dilated cardiomyopathy as well as 12 normal paediatric controls. Cardiac magnetic resonance imaging was performed for ventricular size and function. N-terminal pro-brain natriuretic peptide was collected at this time and the results from the most recent echocardiogram and exercise test were reviewed. We found that patients with dilated cardiomyopathy had significantly faster heart rates, that is, 85 versus 65 beats per minute, lower left ventricular ejection fraction, that is, 42 versus 61%, and right ventricular ejection fraction of 44 versus 54%, lower left and right ventricular stroke volumes, that is, 35.5 versus 49.5 millilitres per square metre and 40.9 versus 56.4 millilitres per square metre, respectively, and lower mitral and tricuspid valve inflow e/a wave velocity ratios of 2.02 versus 2.80 and 1.25 versus 2.58, respectively, than the controls. Tricuspid valve annulus velocity, measured by tissue Doppler echocardiography, correlated with right ventricular ejection fraction (r = 0.60, p = 0.05). Right ventricular ejection fraction and indexed right ventricular end-diastolic volume correlated with N-terminal pro-brain natriuretic peptide (r = 0.67, p = 0.03, r = 0.65, p = 0.04, respectively), and right ventricular ejection fraction correlated with the oxygen uptake at the anaerobic threshold (r = 0.67, p = 0.049). Neither left ventricular ejection fraction nor left ventricular volume correlated with N-terminal pro-brain natriuretic peptide or exercise tolerance. The right ventricular function is decreased in the early stages of dilated cardiomyopathy. Right ventricular size and ejection fraction may be important indicators of sub-clinical cardiac failure and we suggest monitoring them routinely in dilated cardiomyopathy.
KW - Magnetic resonance imaging
KW - echocardiography
KW - ventricular volume
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U2 - 10.1017/S1047951109990540
DO - 10.1017/S1047951109990540
M3 - Article
C2 - 20420745
AN - SCOPUS:78349302361
SN - 1047-9511
VL - 20
SP - 418
EP - 425
JO - Cardiology in the young
JF - Cardiology in the young
IS - 4
ER -