Adults with Ebstein's anomaly—Cardiopulmonary exercise testing and BNP levels

Trojnarska, Olga; Szyszka, Andrzej; Gwizdała, Adrian; Siniawski, Andrzej; Oko−Sarnowska, Zofia; Chmara, Ewa; Straburzyńska‐Migaj, Ewa; Katarzyński, Sławomir; Cieśliński, Andrzej

doi:10.1016/j.ijcard.2005.07.019

Cited by 35 publications

(16 citation statements)

References 35 publications

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“…Both classifications have not been shown to correlate with peak VO 2 or other heart failure markers. 12,23 Moreover, the Severity Index by Celermajer et al 16 calculated from our data in echocardiography and CMR 4CV correlated with only a few heart failure parameters.…”

Section: Discussionmentioning

confidence: 63%

“…This includes clinical presentation (New York Heart association classification), 22 laboratory tests (BNP), 23 ECG (QRS duration), 24,25 cardiopulmonary exercise testing (peak VO 2 , VE/VCO 2 ), 12,23 echocardiography (tricuspid annular plane systolic excursion), 26 and CMR (cardiac index). 13,27,28 The total R/L-volume index simplifies CMR segmentation and takes both atrioventricular (longitudinal) and left-right (transversal) interactions into account.…”

Section: Discussionmentioning

confidence: 99%

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The Total Right/Left-Volume Index: A New and Simplified Cardiac Magnetic Resonance Measure to Evaluate the Severity of Ebstein Anomaly of the Tricuspid Valve

Hösch

Sohns

Nguyen

et al. 2014

Circ: Cardiovascular Imaging

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Background— The classification of clinical severity of Ebstein anomaly still remains a challenge. The aim of this study was to focus on the interaction of the pathologically altered right heart with the anatomically—supposedly—normal left heart and to derive from cardiac magnetic resonance (CMR) a simple imaging measure for the clinical severity of Ebstein anomaly. Methods and Results— Twenty-five patients at a mean age of 26±14 years with unrepaired Ebstein anomaly were examined in a prospective study. Disease severity was classified using CMR volumes and functional measurements in comparison with heart failure markers from clinical data, ECG, laboratory and cardiopulmonary exercise testing, and echocardiography. All examinations were completed within 24 hours. A total right/left-volume index was defined from end-diastolic volume measurements in CMR: total right/left-volume index=(RA+aRV+fRV)/(LA+LV). Mean total right/left-volume index was 2.6±1.7 (normal values: 1.1±0.1). This new total right/left-volume index correlated with almost all clinically used biomarkers of heart failure: brain natriuretic peptide ( r =0.691; P =0.0003), QRS ( r =0.432; P =0.039), peak oxygen consumption/kg ( r =−0.479; P =0.024), ventilatory response to carbon dioxide production at anaerobic threshold ( r =0.426; P =0.048), the severity of tricuspid regurgitation ( r =0.692; P =0.009), tricuspid valve offset ( r =0.583; P =0.004), and tricuspid annular plane systolic excursion ( r =0.554; P =0.006). Previously described severity indices ([RA+aRV]/[fRV+LA+LV]) and fRV/LV end-diastolic volume corresponded only to some parameters. Conclusions— In patients with Ebstein anomaly, the easily acquired index of right-sided to left-sided heart volumes from CMR correlated well with established heart failure markers. Our data suggest that the total right/left-volume index should be used as a new and simplified CMR measure, allowing more accurate assessment of disease severity than previously described scoring systems.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

The Total Right/Left-Volume Index: A New and Simplified Cardiac Magnetic Resonance Measure to Evaluate the Severity of Ebstein Anomaly of the Tricuspid Valve

Hösch

Sohns

Nguyen

et al. 2014

Circ: Cardiovascular Imaging

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show abstract

“…An atrialized ventricle, downward displaced tricuspid valve, and tricuspid regurgitation result in a particular form of right ventricular cardiomyopathy [15]. The so-called asymptomatic patients of Ebstein's anomaly may reveal hemodynamic changes during exercise, which is suggested to be due to tricuspid stenosis [14,24], and the timing of surgery in such patients remains controversial. In the symptomatic patients, tricuspid valvuloplasty or valve replacement provide satisfactory hemodynamic improvement.…”

Section: Discussionmentioning

confidence: 99%

Clinical spectrum and long-term outcome of Ebstein’s anomaly based on a 26-year experience in an Asian cohort

et al. 2008

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Ebstein's anomaly is a rare, congenital cardiac anomaly that may result in cyanosis, right heart failure, and tachyarrhythmia during the newborn stage or after adolescence. This study investigated the data of 77 patients diagnosed between 1980 and 2006 at a tertiary care center in Taiwan. Patients were grouped into either an early group or a late group. Survival declined rapidly within the newborn stage in the early group, but declined only during the third decade in the late group. Surgical results were poor (20% success rate) for neonatal systemic-to-pulmonary shunts in those cases with associated pulmonary atresia, but were satisfactory for other surgical modes. Supraventricular tachyarrhythmia occurred in 31 (41%) patients at a median age of 10 years and could be eliminated by radiofrequency ablation (81% success rate), though the recurrence rate was high (41%). In conclusion, other than those cases requiring shunts at the newborn stage, the long-term outcome was favorable.

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“…Congenital heart diseases have several morphological abnormalities [1][2][3][4][5][6][7][8][9][10][11]and it is very important to recognize the spatial relationship of abnormal structures accurately before deciding on a surgical strategy [12][13][14][15][16][17]. Conventional angiogram has been considered a gold standard to evaluate the abnormal structures but the images are two-dimensional and sometimes it is difficult to recognize the complex spatial relationship of abnormalities three-dimensionally.…”

Section: Discussionmentioning

confidence: 99%

Coarctation of the descending aorta, patent ductus arteriosus, deficiency of right superior vena cava, and persistent left superior vena cava in a five-month infant demonstrated by multislice computed tomography

Uehara

Funabashi

Yasukawa

et al. 2007

International Journal of Cardiology

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Adults with Ebstein's anomaly—Cardiopulmonary exercise testing and BNP levels

Cited by 35 publications

References 35 publications

The Total Right/Left-Volume Index: A New and Simplified Cardiac Magnetic Resonance Measure to Evaluate the Severity of Ebstein Anomaly of the Tricuspid Valve

The Total Right/Left-Volume Index: A New and Simplified Cardiac Magnetic Resonance Measure to Evaluate the Severity of Ebstein Anomaly of the Tricuspid Valve

Clinical spectrum and long-term outcome of Ebstein’s anomaly based on a 26-year experience in an Asian cohort

Coarctation of the descending aorta, patent ductus arteriosus, deficiency of right superior vena cava, and persistent left superior vena cava in a five-month infant demonstrated by multislice computed tomography

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