Mid-term differences in right ventricular function in patients with congenital diaphragmatic hernia compared with contro
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Mid-term differences in right ventricular function in patients with congenital diaphragmatic hernia compared with controls Matthew J Egan, Nazia Husain, Jack R Stines, Nasser Moiduddin, Melanie A Stein, Leif D Nelin, Clifford L Cua Columbus, OH, USA
Original article
Background: Patients with congenital diaphragmatic hernia (CDH) may have abnormal lung development, which may cause detrimental effects on right ventricular (RV) function. This study aimed to determine if there are persistent echocardiographic differences in RV function in patients with CDH years after repair versus control patients. Methods: Patients who underwent repair for CDH were recruited. RV function was evaluated by strain analysis and tissue Doppler imaging (TDI). Wilcoxon's rank-sum test was used for analysis. Results: Seven CDH patients and 16 control patients were studied. There was no difference in age between the CDH and control groups (6.2±1.7 years vs. 5.7±1.7 years). TDI demonstrated significantly lower values in the RV early diastolic wave (12.8±1.5 cm/s vs. 16.1±3.1 cm/ s) and RV systolic wave (10.2± 0.8cm/s vs. 13.4±1.3 cm/s) when comparing the CDH group and the control group. Interventricular apical septal strain was significantly lower in the CDH group than in the control group (-20.1±4.6% vs. -25.4±4.1%). There was a trend towards lower strain values in the RV mid-lateral segment in the CDH group (-30.8±9.9% versus -39.7±6.0%, P=0.06) and a lower global RV strain (-27.8±3.0% vs. -31.1±3.1%, P=0.06). Conclusions: Patients who underwent CDH repair continue to have differences in RV function years after repair. Follow-up is needed to determine how these differences impact cardiac function in adult survivors of CDH. World J Pediatr 2012;8(4):350-354
Author Affiliations: The Heart Center (Egan MJ, Husain N, Stines JR, Moiduddin N, Cua CL) and Center for Perinatal Research (Stein MA, Nelin LD), Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA Corresponding Author: Clifford L Cua, MD, Assistant Professor of Pediatrics, Nationwide Children's Hospital 700 Children's Hospital, Columbus, OH 43205, USA (Tel: 614-722-2530; Fax: 614-722-2549; Email: [email protected]) doi: 10.1007/s12519-012-0380-2 ©Children's Hospital, Zhejiang University School of Medicine, China and Springer-Verlag Berlin Heidelberg 2012. All rights reserved.
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Key words: cardiology; congenital diaphragmatic hernia; echocardiography; strain
Introduction
P
atients born with congenital diaphragmatic hernia (CDH) may have abnormal pulmonary artery development which can contribute to numerous short and long-term sequelae.[1-3] Pulmonary hypertension is a frequent problem in patients with CDH in the newborn period which may persist in certain children and require long-term follow-up and various medical therapies.[4] Pulmonary hypoplasia and pulmonary hypertension have detrimental effects on the function of the right ventricle (RV).[5] Quantification of the RV function is challenging by 2-dimensional echocardiographic techniques secondary to th
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