Evidence map›Paper›PMID 36929330›Full record

ArticleThe international journal of cardiovascular imaging2023

Impact of right ventricular stiffness on discordance between hemodynamic parameter and regurgitant volume in patients with pulmonary regurgitation.

Ko Motoi, Hiroyuki Iwano, Satonori Tsuneta, Suguru Ishizaka, Yoji Tamaki, Hiroyuki Aoyagi, Kosuke Nakamura, Michito Murayama, Masahiro Nakabachi, Shinobu Yokoyama and 4 more

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Article in The international journal of cardiovascular imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 96% 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

1 citing paper in PubMed, 0 citations in OpenAlex.

  1. Article
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

14 authors at 3 institutions in 1 country.

Ko MotoiDepartment of Cardiovascular Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, 060-8638, Sapporo, Japan.
Hiroyuki IwanoDivision of Cardiology, Teine Keijinkai Hospital, 1-12-1-40,Maeda,Teine-ku, 006- 8555, Sapporo, Japan. iwano-hi@keijinkai.or.jp.
Satonori TsunetaDepartment of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita- 14, Nishi-5, Kita-ku, 060-8638, Sapporo, Japan.
Suguru IshizakaDepartment of Cardiovascular Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, 060-8638, Sapporo, Japan.
Yoji TamakiDepartment of Cardiovascular Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, 060-8638, Sapporo, Japan.
Hiroyuki AoyagiDepartment of Cardiovascular Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, 060-8638, Sapporo, Japan.
Kosuke NakamuraDepartment of Cardiovascular Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, 060-8638, Sapporo, Japan.
Michito MurayamaDiagnostic Center for Sonography, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan.
Masahiro NakabachiDivision of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita- 14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan.
Shinobu YokoyamaDivision of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita- 14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan.
Hisao NishinoDivision of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita- 14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan.
Sanae KagaFaculty of Health Sciences, Hokkaido University, Kita-12, Nishi-5, Kita-ku, 060-0812, Sapporo, Japan.
Atsuhito TakedaDepartment of Pediatrics, Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, 060-8638, Sapporo, Japan.
Toshihisa AnzaiDepartment of Cardiovascular Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, 060-8638, Sapporo, Japan.
Hokkaido University · JPHokkaido University Hospital · JPSapporo University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccurate detection of significant pulmonary regurgitation (PR) is critical in management of patients after right ventricular (RV) outflow reconstruction in Tetralogy of Fallot (TOF) patients, because of its influence on adverse outcomes. Although pressure half time (PHT) of PR velocity is one of the widely used echocardiographic markers of the severity, shortened PHT is suggested to be seen in conditions with increased RV stiffness with mild PR. However, little has been reported about the exact characteristics of patients showing discrepancy between PHT and PR volume in this population.

methodsEchocardiography and cardiac magnetic resonance imaging (MRI) were performed in 74 TOF patients after right ventricular outflow tract (RVOT) reconstruction [32 ± 10 years old]. PHT was measured from the continuous Doppler PR flow velocity profile and PHT < 100 ms was used as a sign of significant PR. Presence of end-diastolic RVOT forward flow was defined as RV restrictive physiology. By using phase-contrast MRI, forward and regurgitant volumes through the RVOT were measured and regurgitation fraction was calculated. Significant PR was defined as regurgitant fraction ≥ 25%.

resultsSignificant PR was observed in 54 of 74 patients. While PHT < 100 ms well predicted significant PR with sensitivity of 96%, specificity of 52%, and c-index of 0.72, 10 patients showed shortened PHT despite regurgitant fraction < 25% (discordant group). Tricuspid annular plane systolic excursion and left ventricular (LV) ejection fraction were comparable between discordant group and patients showing PHT < 100 ms and regurgitant fraction ≥ 25% (concordant group). However, discordant group showed significantly smaller mid RV diameter (30.7 ± 4.5 vs. 39.2 ± 7.3 mm, P < 0.001) and higher prevalence of restrictive physiology (100% vs. 42%, P < 0.01) than concordant group. When mid RV diameter ≥ 32 mm and presence of restrictive physiology were added to PHT, the predictive value was significantly improved (sensitivity: 81%, specificity: 90%, and c-index: 0.89, P < 0.001 vs. PHT alone by multivariable logistic regression model).

conclusionPatients with increased RV stiffness and non-enlarged right ventricle showed short PHT despite mild PR. Although it has been expected, this was the first study to demonstrate the exact characteristics of patients showing discrepancy between PHT and PR volume in TOF patients after RVOT reconstruction.

Indexed as

Cardiac Surgical ProceduresPulmonary Valve InsufficiencyTetralogy of FallotVentricular Dysfunction, RightAdultHeart VentriclesHemodynamicsHumansMagnetic Resonance ImagingPredictive Value of TestsVentricular Function, RightYoung AdultCardiac magnetic resonance imagingDoppler echocardiographyPulmonary regurgitationTetralogy of Fallot

Identifiers

PMID36929330
OpenAlexW4327544658

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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.