Impact of reduction in right ventricular pressure and/or volume overload by percutaneous pulmonary valve implantation on biventricular response to exercise: An exercise stress real-time CMR study

41Citations
Citations of this article
54Readers
Mendeley users who have this article in their library.

This article is free to access.

Abstract

Aims To assess the impact of relief of pulmonary stenosis (PS) and pulmonary regurgitation (PR) by percutaneous pulmonary valve implantation (PPVI) on biventricular function during exercise stress.Methods and resultsSeventeen patients, who underwent PPVI for PS or PR, were included. Magnetic resonance imaging was performed at rest and during supine exercise stress pre-and within 1-month post-PPVI, using a radial k-t SENSE real-time sequence. In patients with PS (n 9), there was no reserve in right ventricular (RV) ejection fraction (EF) in response to exercise prior to PPVI (48.2 ± 12.1 at rest vs. 48.4 ± 14.8 during exercise, P 0.87). Post-PPVI, reserve in RVEF in response to exercise was re-established (53.4 ± 15.0 at rest vs. 59.6 ± 17.3 during exercise, P 0.003) with improvement in left ventricular stroke volume (LVSV) (45.4 ± 6.2 mL/m2 at rest vs. 52.8 ± 8.8 mL/m2 during exercise, P 0.001). In patients with PR prior to PPVI (n 8), LVSV during exercise increased (43.0 ± 8.5 vs. 54.3 ± 6.6 mL/m2, P < 0.001) due to reduction in PR fraction during exercise (29.2 ± 5.2 vs. 13.6 ± 6.1, P < 0.001). After PPVI, LVSV increased from rest to exercise (48.4 ± 8.8 vs. 57.2 ± 8.1 mL/m2, P < 0.001) due to improved RVEF (45.5 ± 8.3 vs. 50.4 ± 6.9, P 0.001). There was a significantly higher increase in LVSV at exercise from pre-to post-PPVI in PS patients than in PR patients (ΔLVSV 8.2 ± 4.1 vs. Δ2.9 ± 4.1 mL/m2, P 0.01). The reduction in the RV outflow tract gradient correlated significantly with the improvement in LVSV during exercise (r-0.73, P < 0.001). ConclusionPercutaneous pulmonary valve implantation in patients with PS leads to restoration of reserve in RVEF during exercise stress. In patients with PR, SV augmentation improves only mildly post-PPVI. Improvement in SV augmentation during exercise stress after PPVI is dependent mainly on afterload reduction. © 2012 The European Society of Cardiology All rights reserved.

References Powered by Scopus

Preoperative thresholds for pulmonary valve replacement in patients with corrected tetralogy of Fallot using cardiovascular magnetic resonance

524Citations
N/AReaders
Get full text

Percutaneous pulmonary valve implantation: Impact of evolving technology and learning curve on clinical outcome

420Citations
N/AReaders
Get full text

Biventricular response after pulmonary valve replacement for right ventricular outflow tract dysfunction: is age a predictor of outcome?

273Citations
N/AReaders
Get full text

Cited by Powered by Scopus

Cardiac MRI: A new gold standard for ventricular volume quantification during high-intensity exercise

215Citations
N/AReaders
Get full text

Interaction between respiration and right versus left ventricular volumes at rest and during exercise: A real-time cardiac magnetic resonance study

67Citations
N/AReaders
Get full text

Percutaneous pulmonary valve implantation: 5 years of follow-up does age influence outcomes?

61Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Lurz, P., Muthurangu, V., Schuler, P. K., Giardini, A., Schievano, S., Nordmeyer, J., … Taylor, A. M. (2012). Impact of reduction in right ventricular pressure and/or volume overload by percutaneous pulmonary valve implantation on biventricular response to exercise: An exercise stress real-time CMR study. European Heart Journal, 33(19), 2434–2441. https://doi.org/10.1093/eurheartj/ehs200

Readers over time

‘12‘13‘14‘15‘16‘17‘18‘19‘20‘21‘22‘23‘24036912

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 21

64%

Researcher 7

21%

Professor / Associate Prof. 5

15%

Readers' Discipline

Tooltip

Medicine and Dentistry 27

77%

Engineering 4

11%

Sports and Recreations 3

9%

Nursing and Health Professions 1

3%

Save time finding and organizing research with Mendeley

Sign up for free
0