Evidence map›Paper›PMID 33040260›Full record

ArticlePediatric cardiology2021

Right Ventricular Remodeling in Hypoplastic Left Heart Syndrome is Minimally Impacted by Cardiopulmonary Bypass: A Comparison of Norwood vs. Hybrid.

Kandice Mah, Jesus Serrano Lomelin, Timothy Colen, Edythe B Tham, Lily Lin, Luke Eckersley, Jeffrey F Smallhorn, Harald Becher, Luc Mertens, Nee Scze Khoo

Abstract readComparative StudyMulticenter Study
PubMed Publisher
In one paragraph

Article in Pediatric cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Kandice MahDivision of Pediatric Cardiology, Stollery Children's Hospital, 8440 112 St NW, unit 4C2.36, Edmonton, AB, T6G2B7, Canada.
Jesus Serrano LomelinDivision of Pediatric Cardiology, Stollery Children's Hospital, 8440 112 St NW, unit 4C2.36, Edmonton, AB, T6G2B7, Canada.
Timothy ColenDivision of Pediatric Cardiology, Stollery Children's Hospital, 8440 112 St NW, unit 4C2.36, Edmonton, AB, T6G2B7, Canada.
Edythe B ThamDivision of Pediatric Cardiology, Stollery Children's Hospital, 8440 112 St NW, unit 4C2.36, Edmonton, AB, T6G2B7, Canada.
Lily LinDivision of Pediatric Cardiology, Stollery Children's Hospital, 8440 112 St NW, unit 4C2.36, Edmonton, AB, T6G2B7, Canada.
Luke EckersleyDivision of Pediatric Cardiology, Stollery Children's Hospital, 8440 112 St NW, unit 4C2.36, Edmonton, AB, T6G2B7, Canada.
Jeffrey F SmallhornDivision of Pediatric Cardiology, Stollery Children's Hospital, 8440 112 St NW, unit 4C2.36, Edmonton, AB, T6G2B7, Canada.
Harald BecherMazankowski Alberta Heart Institute, Alberta Health Services, 11220 83 Ave NW, Edmonton, AB, T6G 2B7, Canada.
Luc MertensLabatt Family Heart Centre, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G1X8, Canada.
Nee Scze KhooDivision of Pediatric Cardiology, Stollery Children's Hospital, 8440 112 St NW, unit 4C2.36, Edmonton, AB, T6G2B7, Canada. khoo@ualberta.ca.
Stollery Children's Hospital · CAAlberta Health Services · CAHospital for Sick Children · CA

Funding

Women and Children's Health Research Institute 1,600
6 · The paper itself

Abstract

Right ventricular (RV) remodeling in hypoplastic left heart syndrome (HLHS) begins prenatally and continues through staged palliations. However, it is unclear if the most marked observed remodeling post-Norwood is secondary to cardiopulmonary bypass (CPB) exposure or if it is an adaptation intrinsic to the systemic RV. This study aims to determine the impact of CPB on RV remodeling in HLHS. Echocardiograms of HLHS survivors undergoing stage 1 Norwood (n = 26) or Hybrid (n = 20) were analyzed at pre- and post-stage 1, pre- and post-bidirectional cavo-pulmonary anastomosis (BCPA), and pre-Fontan. RV fractional area change (FAC), vector velocity imaging for longitudinal & derived circumferential deformation (global radial shortening (GRS) = peak radial displacement/end-diastolic diameter), and deformation ratio (longitudinal/ circumferential) were assessed. Both groups had similar age, clinical status and functional parameters pre-stage 1. No difference in RV size and sphericity at any stage between groups. RVFAC was normal (> 35%) throughout for both groups. Both Norwood and Hybrid patients had increased GRS (p = 0.0001) post-stage 1 and corresponding unchanged longitudinal strain, resulting in decreased deformation ratio (greater relative RV circumferential contraction), p = 0.0001. Deformation ratio remained decreased in both groups in subsequent stages. Irrespective of timing of the first CPB exposure, both Norwood and Hybrid patients underwent similar RV remodeling, with relative increase in circumferential to longitudinal contraction soon after stage 1 palliation. The observed RV remodeling in HLHS survivors were minimally impacted by CPB.

Indexed as

Ventricular RemodelingCardiopulmonary BypassEchocardiographyFemaleFontan ProcedureHeart VentriclesHumansHypoplastic Left Heart SyndromeInfantInfant, NewbornMaleNorwood ProceduresPalliative CareRetrospective StudiesAdaptationCardiac functionHypoplastic left heart syndromeSingle ventricle

Identifiers

PMID33040260
OpenAlexW3092247422

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.