Developmental modulation of myocardial mechanics: Age- and growth-related alterations in afterload and contractility

Colan, Steven D.; Parness, Ira A.; Spevak, Philip J.; Sanders, Stephen P.

doi:10.1016/s0735-1097(10)80282-7

Cited by 263 publications

(140 citation statements)

References 68 publications

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“…In the present study, we have shown that the measures of left heart size, including LVDD, LVSD, and aortic annulus dimension, correlate with worsening anemia. The LV mass showed a significant increase in all SCA patients, relative to published normal values [24], and its severity progressed with the degree of anemia. Cardiac output also increased in proportion to the degree of anemia.…”

Section: Clinical Findingsmentioning

confidence: 60%

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Cardiac abnormalities in children with sickle cell anemia

et al. 2002

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Sickle cell anemia (SCA) results in chronic volume overload of the heart due to hemodilution. Previous echocardiographic studies of cardiac function in children with SCA have not accounted for these abnormal loading conditions. The objectives of this study were to (1) determine how the degree of anemia and transfusion status relate to cardiac findings and (2) evaluate cardiac function using load-independent parameters of function. We evaluated 77 patients with SCA, ages 2 to 22 years (mean ± SD = 11.7 ± 4.7), using physical examination, electrocardiography, and echocardiography. We compared two groups of patients. Group 1 consisted of 57 non-transfused patients, and Group 2 consisted of 20 patients on a chronic transfusion protocol. Group 1 patients exhibited a significantly lower hemoglobin, higher cardiac output, and larger left ventricular (LV) end-diastolic dimension and LV mass than groups 2 (P < 0.05). However, the velocity of circumferential fiber shortening-wall stress index (a load-independent measure of systolic function) was normal and not statistically different between the two groups. Conversely, the LV myocardial performance index (a measure of combined systolic and diastolic function) was significantly higher in Group 2 (P < 0.001), possibly indicating impaired myocardial diastolic function. SCA in children results in a volume-overloaded heart with a significant increase in LV dimensions and mass, both proportional to the degree of anemia. Despite these abnormal loading conditions, systolic function is preserved. Patients on a chronic transfusion protocol may develop diastolic dysfunction despite iron chelation therapy. Am.

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Section: Clinical Findingsmentioning

confidence: 60%

“…Cardiac dimensions for the SCA patients were compared to values from the normal predicted equations [24], and each observed value was then expressed as a standard deviation (SD) from the normal predicted value (Zscore).…”

Section: Discussionmentioning

confidence: 99%

Cardiac abnormalities in children with sickle cell anemia

et al. 2002

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“…13 Left ventricular end-diastolic dimension, free wall thickness, septal thickness, and mass were expressed as z scores relative to the distribution of these measurements versus body surface area in normal children, 14 and fractional shortening was expressed as the z score relative to age. 15 Incidence estimates are based on the prospective cohort from the 2 geographic regions for 1996 through 2000 using methods described elsewhere. 12 The distributions of categorical variables by groups were compared using the Fisher exact test unless otherwise noted.…”

Section: Colan Et Al Hypertrophic Cardiomyopathy In Childrenstatisticmentioning

confidence: 99%

Epidemiology and Cause-Specific Outcome of Hypertrophic Cardiomyopathy in Children

et al. 2007

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Background-Current information on the epidemiology and outcomes of hypertrophic cardiomyopathy (HCM) in children is limited by disease diversity and small case series. Methods and Results-The Pediatric Cardiomyopathy Registry has collected prospective and retrospective data on children diagnosed with HCM since 1990. We identified the various causes of HCM in childhood and determined the relationship between outcomes, cause, and age at presentation. Of 855 patients Ͻ18 years of age with HCM, 8.7% (nϭ74) had inborn errors of metabolism, 9.0% (nϭ77) had malformation syndromes, 7.5% (nϭ64) had neuromuscular disorders, and 74.2% (nϭ634) had idiopathic HCM. Children with HCM associated with inborn errors of metabolism and malformation syndromes have significantly worse survival than the other 2 groups. Patients with idiopathic HCM diagnosed before 1 year of age (nϭ227) had worse survival from the time of diagnosis than those diagnosed after 1 year of age (nϭ407). Patients with idiopathic HCM who survived to at least 1 year of age, however, had an annual mortality rate of 1% that was similar regardless of whether they were diagnosed before or after 1 year of age. Conclusions-In children, HCM is a diverse disorder with outcomes that depend largely on cause and age. Patients presenting before 1 year of age have the broadest spectrum of causes and the poorest outcome. In those children with idiopathic HCM who survive beyond age 1, however, survival is independent of age at diagnosis, with an annual mortality rate (1%) that is much lower than previously reported in children and is not different from has been found in population-based studies in adults.

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“…29 Afterload (>74 g/cm 2 5 abnormal) was approximated by left ventricular end-systolic wall stress. 30 …”

Section: Study Assessments Cardiac Assessmentmentioning

confidence: 99%

Subclinical late cardiac toxicity in childhood cancer survivors

Cox

Shesh

Rosenthal

et al. 2008

Cancer

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BACKGROUNDThe authors analyzed how self‐reported health and self‐reported modified New York Heart Association (NYHA) cardiac function scores were related to cardiac systolic function, cardiac risk factors, and cancer treatment history in childhood cancer survivors who reported no symptoms of cardiac disease.METHODSLong‐term survivors of pediatric cancer who were treated between 1971 and 1995 (current ages, 16–39.7 years) underwent noninvasive clinical and laboratory cardiac risk evaluation and responded to selected subscales of the Medical Outcomes Study 36‐item Short Form Health Survey. Results were compared with survivor history of anthracycline therapy alone or with radiotherapy (n = 127 patients; mean, 10 years after diagnosis) versus no anthracycline therapy (n = 32 patients; mean, 11 years after diagnosis).RESULTSSex, current age, highest school grade completed, race, age at diagnosis, diagnostic group, years off therapy, fractional shortening (FS), heart rate, and smoking status were found to be independently predictive of self‐reported health. Interaction between female sex and higher low‐density lipoprotein values and between diagnosis and abnormal FS variably predicted low reported vitality and low reported modified New York Heart Association (NYHA) scores. Echocardiographic findings, cardiac risk factors, and treatment history explained 13% to 28% of the variance in perceived health and self‐reported modified NYHA scores.CONCLUSIONSSystolic function and cardiac risk factors were linked to lower self‐reported health and NYHA scores even in the absence of clinically evident cardiotoxicity. Cancer 2008. ©2008 American Cancer Society.

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Developmental modulation of myocardial mechanics: Age- and growth-related alterations in afterload and contractility

Cited by 263 publications

References 68 publications

Cardiac abnormalities in children with sickle cell anemia

Cardiac abnormalities in children with sickle cell anemia

Epidemiology and Cause-Specific Outcome of Hypertrophic Cardiomyopathy in Children

Subclinical late cardiac toxicity in childhood cancer survivors

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