Right ventricular restrictive physiology in repaired tetralogy of Fallot is associated with smaller respiratory variability

Jae Young Choi, Hae Sik Kwon, Byung Won Yoo, Jaeil Shin, Jun Hee Sul, Han Ki Park, Young Hwan Park

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Long-term outcomes of patients with repaired tetralogy of Fallot (TOF) are known to be related with right ventricular (RV) volume overload, severity of pulmonary insufficiency (PI) and the type of outflow repair. Right ventricular restrictive physiology (RVRP) has also been reported to interfere with several factors influencing the late result in repaired TOF patients. However, the mechanism and physiology of this unique myocardial property in the chronically overloaded right ventricle are not yet clearly understood. Methods: We investigated 43 patients after repair of TOF to assess the relationships among biventricular diastolic function, volume characteristics, and influence of respiratory effort. The patients were classified into 3 groups; 15 patients with RVRP and significant PI (RP group, 35%), 19 without RVRP in the presence of significant PI (NR + PI group, 44%), and 9 without RP or significant PI (NR - PI group, 21%). Doppler spectrals obtained by echocardiography from systemic and pulmonary veins, main pulmonary artery (MPA), and both ventricular inlets, and biventricular diastolic function were compared according to the respiratory cycle. Results: The RP group revealed higher pulmonary venous systolic/diastolic flow ratio (S/D ratio) and the NR + PI group showed larger velocity-time integral (VTI) ratio of total regurgitant/antegrade flow at the MPA and more respiratory variability in the systemic vein. Conclusion: RP is associated with less volume overload of the RV and smaller respiratory variability is also associated with the restrictive RV. The diastolic function and volume status of the RV may influence the diastolic properties of the left heart.

Original languageEnglish
Pages (from-to)28-35
Number of pages8
JournalInternational Journal of Cardiology
Volume125
Issue number1
DOIs
Publication statusPublished - 2008 Mar 28

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Tetralogy of Fallot
Lung
Pulmonary Artery
Pulmonary Veins
Patient Rights
Heart Ventricles
Echocardiography
Veins

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Choi, Jae Young ; Kwon, Hae Sik ; Yoo, Byung Won ; Shin, Jaeil ; Sul, Jun Hee ; Park, Han Ki ; Park, Young Hwan. / Right ventricular restrictive physiology in repaired tetralogy of Fallot is associated with smaller respiratory variability. In: International Journal of Cardiology. 2008 ; Vol. 125, No. 1. pp. 28-35.
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abstract = "Background: Long-term outcomes of patients with repaired tetralogy of Fallot (TOF) are known to be related with right ventricular (RV) volume overload, severity of pulmonary insufficiency (PI) and the type of outflow repair. Right ventricular restrictive physiology (RVRP) has also been reported to interfere with several factors influencing the late result in repaired TOF patients. However, the mechanism and physiology of this unique myocardial property in the chronically overloaded right ventricle are not yet clearly understood. Methods: We investigated 43 patients after repair of TOF to assess the relationships among biventricular diastolic function, volume characteristics, and influence of respiratory effort. The patients were classified into 3 groups; 15 patients with RVRP and significant PI (RP group, 35{\%}), 19 without RVRP in the presence of significant PI (NR + PI group, 44{\%}), and 9 without RP or significant PI (NR - PI group, 21{\%}). Doppler spectrals obtained by echocardiography from systemic and pulmonary veins, main pulmonary artery (MPA), and both ventricular inlets, and biventricular diastolic function were compared according to the respiratory cycle. Results: The RP group revealed higher pulmonary venous systolic/diastolic flow ratio (S/D ratio) and the NR + PI group showed larger velocity-time integral (VTI) ratio of total regurgitant/antegrade flow at the MPA and more respiratory variability in the systemic vein. Conclusion: RP is associated with less volume overload of the RV and smaller respiratory variability is also associated with the restrictive RV. The diastolic function and volume status of the RV may influence the diastolic properties of the left heart.",
author = "Choi, {Jae Young} and Kwon, {Hae Sik} and Yoo, {Byung Won} and Jaeil Shin and Sul, {Jun Hee} and Park, {Han Ki} and Park, {Young Hwan}",
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Right ventricular restrictive physiology in repaired tetralogy of Fallot is associated with smaller respiratory variability. / Choi, Jae Young; Kwon, Hae Sik; Yoo, Byung Won; Shin, Jaeil; Sul, Jun Hee; Park, Han Ki; Park, Young Hwan.

In: International Journal of Cardiology, Vol. 125, No. 1, 28.03.2008, p. 28-35.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Right ventricular restrictive physiology in repaired tetralogy of Fallot is associated with smaller respiratory variability

AU - Choi, Jae Young

AU - Kwon, Hae Sik

AU - Yoo, Byung Won

AU - Shin, Jaeil

AU - Sul, Jun Hee

AU - Park, Han Ki

AU - Park, Young Hwan

PY - 2008/3/28

Y1 - 2008/3/28

N2 - Background: Long-term outcomes of patients with repaired tetralogy of Fallot (TOF) are known to be related with right ventricular (RV) volume overload, severity of pulmonary insufficiency (PI) and the type of outflow repair. Right ventricular restrictive physiology (RVRP) has also been reported to interfere with several factors influencing the late result in repaired TOF patients. However, the mechanism and physiology of this unique myocardial property in the chronically overloaded right ventricle are not yet clearly understood. Methods: We investigated 43 patients after repair of TOF to assess the relationships among biventricular diastolic function, volume characteristics, and influence of respiratory effort. The patients were classified into 3 groups; 15 patients with RVRP and significant PI (RP group, 35%), 19 without RVRP in the presence of significant PI (NR + PI group, 44%), and 9 without RP or significant PI (NR - PI group, 21%). Doppler spectrals obtained by echocardiography from systemic and pulmonary veins, main pulmonary artery (MPA), and both ventricular inlets, and biventricular diastolic function were compared according to the respiratory cycle. Results: The RP group revealed higher pulmonary venous systolic/diastolic flow ratio (S/D ratio) and the NR + PI group showed larger velocity-time integral (VTI) ratio of total regurgitant/antegrade flow at the MPA and more respiratory variability in the systemic vein. Conclusion: RP is associated with less volume overload of the RV and smaller respiratory variability is also associated with the restrictive RV. The diastolic function and volume status of the RV may influence the diastolic properties of the left heart.

AB - Background: Long-term outcomes of patients with repaired tetralogy of Fallot (TOF) are known to be related with right ventricular (RV) volume overload, severity of pulmonary insufficiency (PI) and the type of outflow repair. Right ventricular restrictive physiology (RVRP) has also been reported to interfere with several factors influencing the late result in repaired TOF patients. However, the mechanism and physiology of this unique myocardial property in the chronically overloaded right ventricle are not yet clearly understood. Methods: We investigated 43 patients after repair of TOF to assess the relationships among biventricular diastolic function, volume characteristics, and influence of respiratory effort. The patients were classified into 3 groups; 15 patients with RVRP and significant PI (RP group, 35%), 19 without RVRP in the presence of significant PI (NR + PI group, 44%), and 9 without RP or significant PI (NR - PI group, 21%). Doppler spectrals obtained by echocardiography from systemic and pulmonary veins, main pulmonary artery (MPA), and both ventricular inlets, and biventricular diastolic function were compared according to the respiratory cycle. Results: The RP group revealed higher pulmonary venous systolic/diastolic flow ratio (S/D ratio) and the NR + PI group showed larger velocity-time integral (VTI) ratio of total regurgitant/antegrade flow at the MPA and more respiratory variability in the systemic vein. Conclusion: RP is associated with less volume overload of the RV and smaller respiratory variability is also associated with the restrictive RV. The diastolic function and volume status of the RV may influence the diastolic properties of the left heart.

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