ArticleInternational journal of cardiology2017
Pressure-volume loop-derived cardiac indices during dobutamine stress: a step towards understanding limitations in cardiac output in children with hypoplastic left heart syndrome.
Article in International journal of cardiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 29 citations in OpenAlex.
- Multimodal Imaging from Fetal to Adult Life: A Comprehensive Approach to Hypoplastic Left Heart Syndrome (HLHS).Journal of cardiovascular development and disease · 2025Review
- Impact of cardiovascular magnetic resonance in single ventricle physiology: a narrative review.Cardiovascular diagnosis and therapy · 2024Review
- Hemodynamic inefficiencies during stress hold key for comprehensive assessment after Fontan operation.JTCVS techniques · 2024Article
- Respiratory Muscle Function and Exercise Performance in Adult Patients with Fontan Circulation.Journal of clinical medicine · 2023Article
- Exercise-dependent changes in ventricular-arterial coupling and aortopulmonary collateral flow in Fontan patients: a real-time CMR study.European heart journal. Cardiovascular Imaging · 2022Article
- Non-invasive quantification of pressure-volume loops in patients with Fontan circulation.BMC cardiovascular disorders · 2022Article
- Dobutamine stress testing for the evaluation of atrial and diastolic ventricular function in Fontan patients.Open heart · 2021Article
- Dobutamine stress testing in patients with Fontan circulation augmented by biomechanical modeling.PloS one · 2020Article
- Acute Change in Ventricular Contractility-Load Coupling After Corrective Surgery for Congenital Heart Defect: A Retrospective Cohort Study.Pediatric cardiology · 2019Article
- Efficacy of Sports Club Activities on Exercise Tolerance Among Japanese Middle and High School Children and Adolescents After Fontan Procedure.Pediatric cardiology · 2018Observational
- Exploring kinetic energy as a new marker of cardiac function in the single ventricle circulation.Journal of applied physiology (Bethesda, Md. : 1985) · 2018Article
- Right Ventricular-Pulmonary Vascular Interactions.Physiology (Bethesda, Md.) · 2017Review
- Clinical Applications of Pressure-Volume Assessment in Congenital Heart Disease.Journal of the Society for Cardiovascular Angiography & InterventionsReview
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChildren with a single systemic right ventricle, such as in hypoplastic left heart syndrome (HLHS), frequently experience reduced exercise capacity. Elucidating the causes could help with optimising treatment strategies.
methodsProspective data from 10 consecutive symptomatic patients with HLHS undergoing clinical cardiac magnetic resonance with catheterisation (XMR) were analysed. Mean age 8.6years (range 3.5-11.6years), mean time since Fontan completion 5.5years. MR-compatible catheters were placed in the systemic right ventricle and branch pulmonary arteries to record pressures at rest, with dobutamine infusion at 10mcg/kg/min and at 20mcg/kg/min. Cine short-axis stacks of the ventricle were performed at each condition and used to construct pressure-volume loops.
resultsCompared to rest, cardiac index increased with low-dose dobutamine (p<0.01) with no further rise at peak stress despite a further, albeit, blunted rise in heart rate (p=0.002). A fall in stroke volume occurred (p=0.014) despite good contractility (74% increase, p=0.045) and a well-coupled ventriculo-arterial ratio. End-diastolic pressure and early active relaxation, markers of diastolic function, were normal at rest. However, preload fell at peak stress (p<0.008) while pulmonary vascular resistance (PVR) was low throughout. This group of HLHS patients demonstrated a fall in SV at peak stress, coinciding with a fall in preload.
conclusionsMarkers of systolic and diastolic function remained normal. Failure to adequately fill the ventricle implies a ceiling of maximal flow through the Fontan circuit despite low PVR.
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