Maja Blessing, Hermann Körperich, Peter Barth, Miriam Michel, Otto Dubowy, Sophia Forreiter, Kai Thorsten Laser
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Conventional quantitative blood flow measurements were used to quantify and differentiate between low (group A) and high (group B) collateral flow.</p><p><strong>Results: </strong>Group B showed significantly lower SV i IVC in inspiration, end-inspiration, expiration, and SV i ΔIVC compared with group A (23.6±4.8 mL/m 2 to 33.4±8.0; P =0.005). PV flow resulted in a lower mean SV i PV (11.6±7.6 mL/m 2 , vs. 14.0±11.4 mL/m 2 ) as well as a significantly lower peak systolic S-wave velocity (S max ) ( P =0.005), S/D-ratio (S max /peak diastolic wave velocity) ( P =0.015), and shorter diastolic deceleration time (DT D ; P =0.030; median DT D =134 ms) compared with group A (DT D =202 ms).</p><p><strong>Conclusions: </strong>This study demonstrates the incapability of Fontan patients to properly increase preload by inspiration in the presence of significant collateral flow. The results further show that collateral flow is associated with a volume-deprived ventricle and impaired diastolic function.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Influence of Respiration on Collateral Flow in the Fontan Population Using Real-time Phase-contrast Cardiovascular Magnetic Resonance: Collateral Flow Does Not Protect the Ventricle From Volume Deficiency and Diastolic Dysfunction.\",\"authors\":\"Maja Blessing, Hermann Körperich, Peter Barth, Miriam Michel, Otto Dubowy, Sophia Forreiter, Kai Thorsten Laser\",\"doi\":\"10.1097/RTI.0000000000000684\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The clinical significance of collateral flow for the ventricular function of patients with univentricular hearts is often debated. 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引用次数: 0
摘要
目的:侧枝血流对单室心脏患者心室功能的临床意义一直存在争议。本研究通过系统和肺静脉(PV)血流模式评估侧支血流对Fontan患者呼吸依赖的预负荷调节和舒张功能的影响。材料与方法:对21例Fontan患者和11例健康人进行右上PV、升主动脉、上下腔静脉(IVC)实时相衬心血管磁共振。将患者的呼吸周期分为4期,生成呼吸依赖脑卒中容积(SV i)。常规定量血流量测量用于量化和区分低(A组)和高(B组)侧支流量。结果:B组吸气、吸气末、呼气、SV i IVC均明显低于A组(23.6±4.8 mL/ m2 ~ 33.4±8.0 mL/ m2);P = 0.005)。PV血流导致平均SV i PV(11.6±7.6 mL/ m2, vs. 14.0±11.4 mL/ m2)降低,收缩期S波速度峰值(S max) (P =0.005), S/D比(S max /舒张期波速峰值)(P =0.015)显著降低,舒张期减速时间(DT D;P = 0.030;中位DT D =134 ms),与A组相比(DT D =202 ms)。结论:本研究表明Fontan患者在存在明显侧支血流的情况下无法通过吸气适当增加预负荷。结果进一步表明侧支血流与心室容量不足和舒张功能受损有关。
Influence of Respiration on Collateral Flow in the Fontan Population Using Real-time Phase-contrast Cardiovascular Magnetic Resonance: Collateral Flow Does Not Protect the Ventricle From Volume Deficiency and Diastolic Dysfunction.
Purpose: The clinical significance of collateral flow for the ventricular function of patients with univentricular hearts is often debated. This study evaluates the impact of collateral flow on respiration-dependent preload modification and diastolic function in Fontan patients assessed by systemic and pulmonary vein (PV) flow patterns.
Materials and methods: Real-time phase-contrast cardiovascular magnetic resonance was performed in the right upper PV, ascending aorta, superior, and inferior vena cava (IVC) in 21 Fontan patients and 11 healthy individuals. The patients' respiratory cycle was divided into 4 periods to generate respiratory-dependent stroke volumes (SV i ). Conventional quantitative blood flow measurements were used to quantify and differentiate between low (group A) and high (group B) collateral flow.
Results: Group B showed significantly lower SV i IVC in inspiration, end-inspiration, expiration, and SV i ΔIVC compared with group A (23.6±4.8 mL/m 2 to 33.4±8.0; P =0.005). PV flow resulted in a lower mean SV i PV (11.6±7.6 mL/m 2 , vs. 14.0±11.4 mL/m 2 ) as well as a significantly lower peak systolic S-wave velocity (S max ) ( P =0.005), S/D-ratio (S max /peak diastolic wave velocity) ( P =0.015), and shorter diastolic deceleration time (DT D ; P =0.030; median DT D =134 ms) compared with group A (DT D =202 ms).
Conclusions: This study demonstrates the incapability of Fontan patients to properly increase preload by inspiration in the presence of significant collateral flow. The results further show that collateral flow is associated with a volume-deprived ventricle and impaired diastolic function.
期刊介绍:
Journal of Thoracic Imaging (JTI) provides authoritative information on all aspects of the use of imaging techniques in the diagnosis of cardiac and pulmonary diseases. Original articles and analytical reviews published in this timely journal provide the very latest thinking of leading experts concerning the use of chest radiography, computed tomography, magnetic resonance imaging, positron emission tomography, ultrasound, and all other promising imaging techniques in cardiopulmonary radiology.
Official Journal of the Society of Thoracic Radiology:
Japanese Society of Thoracic Radiology
Korean Society of Thoracic Radiology
European Society of Thoracic Imaging.