Disrupted right ventricular force-frequency relationships in adults operated for ventricular septal defect as toddlers: abnormal peak force predicts peak oxygen uptake during exercise
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Disrupted right ventricular force-frequency relationships in adults operated for ventricular septal defect as toddlers : abnormal peak force predicts peak oxygen uptake during exercise. / Heiberg, Johan; Schmidt, Michael Rahbek; Redington, Andrew; Hjortdal, Vibeke Elisabeth.
In: International Journal of Cardiology, Vol. 177, No. 3, 20.12.2014, p. 918-24.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Disrupted right ventricular force-frequency relationships in adults operated for ventricular septal defect as toddlers
T2 - abnormal peak force predicts peak oxygen uptake during exercise
AU - Heiberg, Johan
AU - Schmidt, Michael Rahbek
AU - Redington, Andrew
AU - Hjortdal, Vibeke Elisabeth
N1 - Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
PY - 2014/12/20
Y1 - 2014/12/20
N2 - Recent studies have shown markedly reduced functional capacity in long-term survivors of ventricular septal defect (VSD), and in order to explore possible mechanisms, we performed non-invasive assessment of ventricular force-frequency relationships during exercise in adults operated for VSD in early childhood. We conducted a prospective study at a tertiary referral center. Patients (n=23) and healthy controls (n=20) underwent continuous Doppler-echocardiographic imaging during supine bicycle ergometry. The cycling workload was individually and manually incremented during the test session in response to heart rate. The heart was imaged in an apical 4-chamber view, and color-coded myocardial velocities were recorded. Post hoc, peak systolic velocity and isovolumetric acceleration (IVA) were blindly determined in the basal ventricular segments. VSD-operated patients differed markedly in all right ventricular endpoints compared with controls. IVA was lower prior to the test, 70 ± 30 cm/s(2) vs. 150 ± 60 cm/s(2) among controls, and during the entire test session ending at a heart rate of 160 beats/min; 140 ± 50 cm/s(2) vs. 300 ± 30 cm/s(2), p < 0.01 at both points. A similar pattern was revealed in terms of peak right ventricular systolic velocity. Left ventricular and septal measurements showed a similar, although less significant, tendency with a clearly lower left ventricular optimum heart rate among patients: 140 beats/min vs. 154 beats/min among controls. In the diseased cohort biventricular force-frequency relationships were directly correlated to peak oxygen uptake. VSD repair in early childhood is associated with disruption of the right ventricular force-frequency relationship, which may contribute to the previously observed reduction in functional capacity.
AB - Recent studies have shown markedly reduced functional capacity in long-term survivors of ventricular septal defect (VSD), and in order to explore possible mechanisms, we performed non-invasive assessment of ventricular force-frequency relationships during exercise in adults operated for VSD in early childhood. We conducted a prospective study at a tertiary referral center. Patients (n=23) and healthy controls (n=20) underwent continuous Doppler-echocardiographic imaging during supine bicycle ergometry. The cycling workload was individually and manually incremented during the test session in response to heart rate. The heart was imaged in an apical 4-chamber view, and color-coded myocardial velocities were recorded. Post hoc, peak systolic velocity and isovolumetric acceleration (IVA) were blindly determined in the basal ventricular segments. VSD-operated patients differed markedly in all right ventricular endpoints compared with controls. IVA was lower prior to the test, 70 ± 30 cm/s(2) vs. 150 ± 60 cm/s(2) among controls, and during the entire test session ending at a heart rate of 160 beats/min; 140 ± 50 cm/s(2) vs. 300 ± 30 cm/s(2), p < 0.01 at both points. A similar pattern was revealed in terms of peak right ventricular systolic velocity. Left ventricular and septal measurements showed a similar, although less significant, tendency with a clearly lower left ventricular optimum heart rate among patients: 140 beats/min vs. 154 beats/min among controls. In the diseased cohort biventricular force-frequency relationships were directly correlated to peak oxygen uptake. VSD repair in early childhood is associated with disruption of the right ventricular force-frequency relationship, which may contribute to the previously observed reduction in functional capacity.
KW - Adolescent
KW - Adult
KW - Age Factors
KW - Child, Preschool
KW - Cohort Studies
KW - Denmark/epidemiology
KW - Exercise Test/trends
KW - Female
KW - Heart Septal Defects, Ventricular/diagnostic imaging
KW - Humans
KW - Male
KW - Oxygen Consumption/physiology
KW - Predictive Value of Tests
KW - Prospective Studies
KW - Ultrasonography
KW - Ventricular Dysfunction, Right/diagnostic imaging
KW - Young Adult
U2 - 10.1016/j.ijcard.2014.10.009
DO - 10.1016/j.ijcard.2014.10.009
M3 - Journal article
C2 - 25456699
VL - 177
SP - 918
EP - 924
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 3
ER -
ID: 242416287