CLINICAL STUDY: PEDIATRIC CARDIOLOGY
Myocardial flow reserve in patients with a systemic right ventricle after atrial switch repair
Tajinder P. Singh, MD, FACC*,
Richard A. Humes, MD, FACC*,
Otto Muzik, PhD  ,
Sambasiva Kottamasu, MD,
Peter P. Karpawich, MD, FACC* and
Marcelo F. Di Carli, MD, FACC
* Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, USA
Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
Radiology, and the PET Center, Wayne State University School of Medicine, Detroit, Michigan, USA
Children’s Hospital of Michigan, Detroit, Michigan, USA
Manuscript received November 20, 2000;
revised manuscript received February 20, 2001,
accepted March 1, 2001.
Reprint requests and correspondence: Dr. T. P. Singh, Division of Cardiology, Children’s Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, Michigan 48111
tsingh{at}dmc.org
OBJECTIVES
The purpose of this study was to assess myocardial blood flow (MBF) and flow reserve in systemic right ventricles (RV) in long-term survivors of the Mustard operation.
BACKGROUND
There is a high prevalence of systemic RV dysfunction and impaired exercise performance in long-term survivors of the Mustard operation. A mismatch between myocardial blood supply and systemic ventricular work demand has been proposed as a potential mechanism.
METHODS
We assessed MBF at rest and during intravenous adenosine hyperemia in 11 long-term survivors of a Mustard repair (age 18 ± 5 years, median age at repair 0.7 years, follow-up after repair 17 ± 5 years) and 13 healthy control subjects (age 23 ± 7 years), using N-13 ammonia and positron emission tomography imaging.
RESULTS
There was no difference in basal MBF between the systemic RV of survivors of the Mustard operation and the systemic left ventricle (LV) of healthy control subjects (0.80 ± 0.19 vs. 0.74 ± 0.15 ml/g/min, respectively, p = NS). However, the hyperemic flows were significantly lower in systemic RVs than they were in systemic LVs (2.34 ± 0.0.69 vs. 3.44 ± 0.62 ml/g/min respectively, p < 0.01). As a result, myocardial flow reserve was lower in systemic RVs than it was in systemic LVs (2.93 ± 0.63 vs. 4.74 ± 1.09, respectively, p < 0.01).
CONCLUSIONS
Myocardial flow reserve is impaired in systemic RVs in survivors of the Mustard operation. This may contribute to systemic ventricular dysfunction in these patients.
|
Abbreviations and Acronyms
| | ECG | = electrocardiogram | | FWHM | = full-width half maximum | | LV | = left ventricle or left ventricular | | MBF | = myocardial blood flow | | N-13 | = nitrogen 13 | | PET | = positron emission tomography | | ROI | = region of interest | | RV | = right ventricle or right ventricular |
|
This article has been cited by other articles:
|
|
|
|
 
S. Kutty, J. Olson, C. J. Danford, E. K. Sandene, F. Xie, S. E. Fletcher, C. C. Erickson, J. D. Kugler, D. A. Danford, and T. R. Porter
Ultrasound contrast and real-time perfusion in conjunction with supine bicycle stress echocardiography for comprehensive evaluation of surgically corrected congenital heart disease
Eur Heart J Cardiovasc Imaging,
December 15, 2011;
(2011)
jer287v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Rutz, S. F. de Marchi, M. Schwerzmann, R. Vogel, and C. Seiler
Right ventricular absolute myocardial blood flow in complex congenital heart disease
Heart,
July 1, 2010;
96(13):
1056 - 1062.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S Fratz, M Hauser, F M Bengel, A Hager, H Kaemmerer, M Schwaiger, J Hess, and H C Stern
Myocardial scars determined by delayed-enhancement magnetic resonance imaging and positron emission tomography are not common in right ventricles with systemic function in long-term follow up
Heart,
November 1, 2006;
92(11):
1673 - 1677.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P A Davlouros, K Niwa, G Webb, and M A Gatzoulis
The right ventricle in congenital heart disease
Heart,
April 1, 2006;
92(suppl_1):
i27 - i38.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. F. Tops, A. A. W. Roest, H. J. Lamb, H. W. Vliegen, W. A. Helbing, E. E. van Der Wall, and A. de Roos
Intraatrial Repair of Transposition of the Great Arteries: Use of MR Imaging after Exercise to Evaluate Regional Systemic Right Ventricular Function
Radiology,
December 1, 2005;
237(3):
861 - 867.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. V. Babu-Narayan, O. Goktekin, J. C. Moon, C. S. Broberg, G. A. Pantely, D. J. Pennell, M. A. Gatzoulis, and P. J. Kilner
Late Gadolinium Enhancement Cardiovascular Magnetic Resonance of the Systemic Right Ventricle in Adults With Previous Atrial Redirection Surgery for Transposition of the Great Arteries
Circulation,
April 26, 2005;
111(16):
2091 - 2098.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Janousek, V. Tomek, V. Chaloupecky, O. Reich, R. A. Gebauer, J. Kautzner, and B. Hucin
Cardiac resynchronization therapy: A novel adjunct to the treatment and prevention of systemic right ventricular failure
J. Am. Coll. Cardiol.,
November 2, 2004;
44(9):
1927 - 1931.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.W Roos-Hesselink, F.J Meijboom, S.E.C Spitaels, R van Domburg, E.H.M van Rijen, E.M.W.J Utens, J McGhie, E Bos, A.J.J.C Bogers, and M.L Simoons
Decline in ventricular function and clinical condition after mustard repair for transposition of the great arteries (a prospective study of 22-29 years)
Eur. Heart J.,
July 2, 2004;
25(14):
1264 - 1270.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A A W Roest, H J Lamb, E E van der Wall, H W Vliegen, J G van den Aardweg, P Kunz, A de Roos, and W A Helbing
Cardiovascular response to physical exercise in adult patients after atrial correction for transposition of the great arteries assessed with magnetic resonance imaging
Heart,
June 1, 2004;
90(6):
678 - 684.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M Hauser, F M Bengel, A Hager, A Kuehn, S G Nekolla, H Kaemmerer, M Schwaiger, and J Hess
Impaired myocardial blood flow and coronary flow reserve of the anatomical right systemic ventricle in patients with congenitally corrected transposition of the great arteries
Heart,
October 1, 2003;
89(10):
1231 - 1235.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
