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Biventricular Pressure-Volume Loop Assessment Before and After Pulmonary Valve Replacement in Tetralogy of Fallot

Binka, Edem (author)
Johns Hopkins University School of Medicine
Zhang, Jin (author)
Capital University of Medical Sciences
Seemann, Felicia (author)
Lund University,Lunds universitet,Institutionen för biomedicinsk teknik,Institutioner vid LTH,Lunds Tekniska Högskola,Klinisk fysiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Department of Biomedical Engineering,Departments at LTH,Faculty of Engineering, LTH,Clinical Physiology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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Jani, Vivek (author)
Johns Hopkins University School of Medicine
Barnes, Benjamin (author)
Johns Hopkins University School of Medicine
Gaur, Lasya (author)
Johns Hopkins University School of Medicine
Lima, Joao A.C. (author)
Johns Hopkins University School of Medicine
Ambale Venkatesh, Bharath (author)
Johns Hopkins University School of Medicine
Carlsson, Marcus (author)
Lund University,Lunds universitet,Hjärt-MR-gruppen i Lund,Forskargrupper vid Lunds universitet,Lund Cardiac MR Group,Lund University Research Groups,Skåne University Hospital
Kutty, Shelby (author)
Johns Hopkins University School of Medicine
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 (creator_code:org_t)
2022
2022
English.
In: Journal of Thoracic Imaging. - 0883-5993. ; 37:5, s. 70-71
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Patients with tetralogy of Fallot (TOF) may undergo pulmonary valve replacement (PVR) after initial full repair. We investigated indices of biventricular function, work and efficiency of TOF patients' using noninvasive pressure-volume (PV) loop analysis on cardiovascular magnetic resonance (CMR) images and compared pre-and post PVR groups. Biventricular segmentations of steady state free precession CMR images were performed using custom validated software (Segment version 2.0 R7067). Brachial cuff pressure estimated left ventricular (LV) systolic pressure. Right ventricular (RV) inputs were obtained from pre-PVR cardiac catheterization data. Biventricular PV loops were then derived using a time-varying elastance model. Twenty seven patients were studied: (22 pre-PVR, 5 post-PVR), mean age of 20±10.5 years and 83% male. RV stroke volume significantly differed before and after PVR (73.2±25 ml vs. 41±10 mL, P=0.01). RV stroke work (SW) and mean external power (MEP) were significantly less post-PVR, but there were no significant differences in the LV hemodynamic indices. TOF patients have reduced RV SW and MEP post-PVR suggesting improved hemodynamics. Noninvasive biventricular PV loop analysis shows potential for integration into standard CMR imaging of TOF and provides hemodynamic data that could influence management decisions.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
TEKNIK OCH TEKNOLOGIER  -- Medicinteknik -- Medicinsk bildbehandling (hsv//swe)
ENGINEERING AND TECHNOLOGY  -- Medical Engineering -- Medical Image Processing (hsv//eng)

Keyword

cardiovascular magnetic resonance
pressure-volume loops
tetralogy of Fallot

Publication and Content Type

art (subject category)
ref (subject category)

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