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Right Ventricular and Septal Function in Patients with Pulmonary Hypertension - 04/12/13

Doi : 10.1016/j.hlc.2013.04.116 
A. Tulga Ulus, MD a, , Nilüfer Yıldırım Poyraz, MD b, Nurcan Arat, MD c, Seyhan Babaroğlu, MD a, A. İhsan Parlar, MD a, Soner Yavaş, MD a, Mustafa Ünlü, MD b
a Department of Cardiovascular Surgery, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey 
b Department of Nuclear Medicine, Gazi University Medical Faculty, Ankara, Turkey 
c Department of Cardiology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey 

Corresponding author at: Cardiovascular Surgery Clinic, Türkiye Yüksek Ihtisas Hospital, 06100 Sıhhıye, Ankara, Turkey. Tel.: +90 532 522 15 20; fax: +90 312 229 01 48.

Resumen

Objective

Pulmonary hypertension (PHT) exacerbates the functions of both ventricles. This prospective, randomised study was planned to investigate the effects of PHT on kinetics of both ventricles and the septum.

Methods

Twenty-five patients were randomly selected among the patients who had been planned to undergo mitral valve replacement (MVR) because of isolated mitral stenosis and divided into two groups according to their preoperative pulmonary artery pressure (PAP) values. Blood pool gated single photon emission tomography (BPGS) and transthoracic echocardiography were performed. Ventricles’ regional, global and functional parameters were also assessed by using pulsed wave Doppler tissue imaging (DTI).

Results

Preoperative and postoperative PAP of the group 1 (PAP<50mmHg) were 40.0±2.8 and 30.0±2.6mmHg (p=0.03), group 2 (PAP ≥ 50mmHg) were 71.9±4.7 and 50.6±3.5mmHg (p<0.05). The global right and left ventricle scores were decreased after the operation. The decrement was only significant in group 2. Considering the septal kinetics, right ventricle septal score was decreased from 7.6 to 3.3 (p<0.05) in group 1, from 3.8 to 1.6 (p<0.05) in group 2 postoperatively.

Conclusion

Following MVR, a decrement in PAP values, and an improvement in ventricular function, especially in the right ventricular and septal kinetics were achieved. Furthermore, it was found that both DTI and BPGS techniques are beneficial to investigate the functional changes postoperatively and in the follow-up period of the patients who undergo mitral valve surgery.

El texto completo de este artículo está disponible en PDF.

Keywords : Pulmonary artery hypertension, Mitral stenosis, Mitral valve replacement, Doppler tissue imaging, Blood pool SPECT


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© 2013  Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 22 - N° 12

P. 1003-1010 - décembre 2013 Regresar al número
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