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Left ventricular function in adolescents and adults with restrictive ventricular septal defect and moderate left-to-right shunting

Published online by Cambridge University Press:  19 August 2008

Alan G. Magee ,
Lynn Fenn ,
Joric Vellekoop  and
Michael J. Godman
Alan G. Magee*
Affiliation:
Royal Hospital for Sick Children, Edinburgh, UK
Lynn Fenn
Affiliation:
Western General Hospital, Edinburgh, UK
Joric Vellekoop
Affiliation:
Royal Hospital for Sick Children, Edinburgh, UK
Michael J. Godman
Affiliation:
Royal Hospital for Sick Children, Edinburgh, UK
*
Alan G Magee, Consultant Paediatric Cardiologist, Royal Brompton and Harefield NHS Trust, Sydney Street, London 5W3 6NP, UK Tel 0171 352 8121, Fax 0171 351 8547, E-mail a.magee@rbh.nthames.nhs.uk
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Abstract

Background

The long-term haemodynamic effects of a restrictive ventricular septal defect permitting moderate left-to-right shunting are not known.

Patients and methods

Echocardiographic measure ments of left heart dimensions and function were compared between a group of 9 older children and adults (median age 21 years, range 12–24.5 years) having restrictive ventricular septal defects (median Qp/Qs 1.7, range 1.4–2.1) and a group of 10 age matched controls.

Results

Left ventricular mass indexed to body surface area was significantly greater in subjects than in controls (102±29 vs. 75±13 g/m2, p=0.02), although there was no significant difference in the ratio of mass to volume. There were no significant differ ences between indexes of left ventricular systolic function. Ratios of peak early to late diastolic ventricular filling were lower in those with septal defects (1.5±0.3 vs. 1.8±0.3, p=0.013), but there were no differences in other indexes of diastolic function.

Conclusions

Resting left ventricular function does not appear to have deteriorated by early adult life in patients with restrictive ventricular septal defects and moderate volume loading. This would support a continued conservative approach to management in these patients.

Keywords

Ventricular septal defectleft ventricular functionadult congenital heart disease
Type
Original Articles
Information
Cardiology in the Young , Volume 10 , Issue 2 , March 2000 , pp. 126 - 129
Copyright
Copyright © Cambridge University Press 2000

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References

1.Fyler, DC. Report of the New England regional infant cardiac program. Pediatrics 1980; 65: 376–461.Google Scholar
2.Corone, P, Doyon, F, Gaudeau, S, Guerin, F, Vernant, P, Ducam, H, Rumeau-Rouquette, C, Gaudeul, P. Natural history of ventricular septal defect: a study involving 790 cases. Circulation 1977; 55: 908–915.Google Scholar
3.Okita, Y, Miki, S, Kusuhara, K, Ueda, Y, Tahata, T, Yamanaka, K, Shiraishi, S, Tamura, T, Tatsuta, N, Koie, H. Long-term results of aortic valvuloplasry for aortic regurgitation associated with ventricular septal defect. J Thorac Cardiovasc Surg 1988; 96: 769–774.Google Scholar
4.Breitweser, JA, Gelfand, MJ, Meyer, RA, Dillon, T, Covitz, W, Kaplan, S. Radionuclide angiographic and echocardiographic quantitation of left-to-right shunts in children with ventricular septal defect. Pediatric Cardiology 1982; 3: 7–12.Google Scholar
5.Li, W, Somerville, J. Grown-up Congenital Heart Unit, Royal Brompton Hospital, London, U.K. Infective endocarditis in the grown-up congenital heart (GUCH) population. Eur Heart J 1998; 19: 166–173.CrossRefGoogle Scholar
6.Devereux, RB, Alonso, DR, Lutas, EM, Gottlieb, GJ, Campo, E, Sachs, I, Reichek, N. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 1986; 57: 450–458.Google Scholar
7.Miki, S, Murakami, T, Iwase, T, Tomita, T, Nakamura, Y, Kawai, C. Doppler echocardiographic transmitral peak early velocity does not directly reflect hemodynamic changes in humans: importance of normalization to mitral stroke volume. J Am Coil Cardiol 1991; 17: 1507–1516.Google Scholar
8.Jensen, JL, Williams, FE, Beilby, BJ, Johnson, BL, Miller, LK, Ginter, TL, Tomaselli-Martin, G, Appleton, CR. Feasibility of obtaining pulmonary venous flow velocity in cardiac patients using transthoracic pulsed wave Doppler technique. J Am Soc Echo 1997; 10: 60–66.Google Scholar
9.Rossvoll, O, Hatle, LK. Pulmonary venous flow velocities recorded by transthoracic Doppler ultrasound: relation to left ventricular diastolic pressures. JACC 1993; 21: 1687–1696.CrossRefGoogle ScholarPubMed
10.Riggs, TW, Snider, AR. Respiratory influence on right and left ventricular diastolic function in normal children. AmJ Cardiol 1989; 63: 858–861.Google Scholar
11.Beerman, LB, Park, SC, Fischer, DR, Fricker, FJ, Mathews, RA, Neches, WH, Lenox, CC, Zoberbuhler, JR. Ventricular septal defect associated with aneurysm of the membranous septum. JACC 1985; 5: 118–123.Google Scholar
12.Otterstad, JE, Simonsen, S, Erikssen, J. Haemodynamic findings at rest and during mild supine exercise in adults with isolated, uncomplicated ventricular septal defects. Circulation 1985; 71: 650–662.CrossRefGoogle ScholarPubMed
13.Jablonsky, G, Hilton, JD, Liu, PP, Morch, JE, Druck, MN, Bar-Shlomo, BZ, McLaughlin, PR. Rest and exercise ventricular function in adults with congenital ventricular septal defects. Am J Cardiol 1983; 51: 293–298.CrossRefGoogle ScholarPubMed
14.Peter, CA, Bowyer, K, Jones, RH. Radionuclide analysis of right and left ventricular response to exercise in patients with atrial and ventricular sepral defects. Am Heart J 1983; 105: 428–435.Google Scholar
15.Isaaz, K, Ethevenot, G, Admant, P, Brembilla, B, Pernot, C. A new Doppler method of assessing left ventricular ejection force in chronic congestive heart failure. Am J Cardiol 1989; 64: 81–87.Google Scholar