Interventricular asynchrony in Chronic Thrombo Embolic Pulmonary Hypertension recovers after pulmonary endarterectomy: role of right ventricular wall stress
نویسندگان
چکیده
Methods Reduction of RV wall stress was accomplished by pulmonary endarterectomy (PEA), which is the surgical removal of thrombo-emboli out of the pulmonary arteries. In 13 consecutive patients with CTEPH, MRI myocardial tagging (29 ms temporal resolution) was applied before and after PEA (fig 1). For the left ventricular (LV) free wall, septum (S) and RV free wall, the time to peak (Tpeak) of circumferential shortening was calculated. Pulmonary Artery Pressure (PAP) was measured by right heart catheterization. For the RV free wall, the end-systolic wall stress was calculated by the Laplace law, before and after PEA.
منابع مشابه
Pulmonary endarterectomy normalizes interventricular dyssynchrony and right ventricular systolic wall stress
BACKGROUND Interventricular mechanical dyssynchrony is a characteristic of pulmonary hypertension. We studied the role of right ventricular (RV) wall stress in the recovery of interventricular dyssynchrony, after pulmonary endarterectomy (PEA) in chronic thromboembolic pulmonary hypertension (CTEPH). METHODS In 13 consecutive patients with CTEPH, before and 6 months after pulmonary endarterec...
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Methods In 21 PAH patients (mean pulmonary arterial pressure 55 13 mm Hg and electrocardiogram–QRS width 100 16 ms), magnetic resonance imaging myocardial tagging (14 ms temporal resolution) was applied. For the left ventricular (LV) free wall, septum, and right ventricular (RV) free wall, the onset time (Tonset) and peak time (Tpeak) of circumferential shortening were calculated. The RV wall t...
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AIMS To study whether pre-operative assessment, using echocardiography, of the timing of a particular feature in the pulmonary flow (pulmonary flow systolic notch) may predict in-hospital mortality and mid-term haemodynamic improvement after pulmonary endarterectomy (PEA) for chronic thrombo-embolic pulmonary hypertension (CTEPH). METHODS AND RESULTS Fifty-eight of 61 consecutive CTEPH patien...
متن کامل[Thrombo-embolic pulmonary hypertension--do not spoil a chance for effective surgery!].
Chronic thromboembolic pulmonary hypertension (CTEPH) can be defined as pulmonary hypertension with persistent pulmonary perfusion defects causes by unresolved thrombi. All symptomatic CTEPH patients with documented pulmonary vascular resistance > 300 dyn*sec*cm(-5) and proximal lesions should be considered for surgical treatment--pulmonary endarterectomy. The role of pharmacological treatment ...
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BACKGROUND Delayed left ventricle (LV)-to-right ventricle (RV) peak shortening results in cardiac output reduction in patients with chronic thromboembolic hypertension (CTEPH) and other types of pulmonary arterial hypertension. Why the synchrony between LV and RV is lost is unknown. We hypothesized that RV electrophysiological remodeling, notably, conduction slowing and action potential prolong...
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