Forgotten Right Ventricle in Pediatric Dilated Cardiomyopathy

Agha, Hala Mounir; Ibrahim, Hossam; Satar, Inas Abd El; Rahman, Naglae Abd El; Aziz, Doaa Abd El; Salah, Zeinab; Saeidi, Sonia El; Mostafa, Fatma; Attia, Walid A.; Rahman, Mohamed Abdel; Mohsen, Gaser Abd El

doi:10.1007/s00246-017-1588-7

Cited by 19 publications

(14 citation statements)

References 24 publications

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“…Similar to what has been reported in adult LV failure, RV dysfunction has been reported in severe cases of LV failure in children (Agha et al, 2017). Importantly, guideline approved therapies that are efficacious in adults with dilated cardiomyopathy are not as effective in children with dilated cardiomyopathy (Shaddy et al, 2007;Hsu et al, 2010;Kantor et al, 2010) suggesting that there are age-specific molecular mechanisms at play (Agha et al, 2017). Based on the fact that there are age-specific molecular differences that impact the failing LV, it is highly likely that there are also unique molecular features of the RV that differ across the lifespan and make it imperative to study RV (patho) physiology in all ages.…”

Section: Molecular and Biochemical Properties Of Pediatric Rvsupporting

confidence: 86%

Physiology of the Right Ventricle Across the Lifespan

Woulfe

Walker

2021

Front. Physiol.

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The most common cause of heart failure in the United States is ischemic left heart disease; accordingly, a vast amount of work has been done to elucidate the molecular mechanisms underlying pathologies of the left ventricle (LV) as a general model of heart failure. Until recently, little attention has been paid to the right ventricle (RV) and it has commonly been thought that the mechanical and biochemical properties of the RV are similar to those of the LV. However, therapies used to treat LV failure often fail to improve ventricular function in RV failure underscoring, the need to better understand the unique physiologic and pathophysiologic properties of the RV. Importantly, hemodynamic stresses (such as pressure overload) often underlie right heart failure further differentiating RV failure as unique from LV failure. There are significant structural, mechanical, and biochemical properties distinctive to the RV that influences its function and it is likely that adaptations of the RV occur uniquely across the lifespan. We have previously reviewed the adult RV compared to the LV but there is little known about differences in the pediatric or aged RV. Accordingly, in this mini-review, we will examine the subtle distinctions between the RV and LV that are maintained physiologically across the lifespan and will highlight significant knowledge gaps in our understanding of pediatric and aging RV. Consideration of how RV function is altered in different disease states in an age-specific manner may enable us to define RV function in health and importantly, in response to pathology.

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Section: Molecular and Biochemical Properties Of Pediatric Rvsupporting

confidence: 86%

Physiology of the Right Ventricle Across the Lifespan

Woulfe

Walker

2021

Front. Physiol.

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“…The release of inflammatory mediators due to chronic inflammation of the airway may cause pulmonary vasoconstriction and distortion of pulmonary vasculature . The left ventricle (LV) could be affected secondary to RV involvement due to ventricular interdependence …”

Section: Introductionmentioning

confidence: 99%

“…This technique is, however, angle‐dependent and is affected by translational heart movements . 2D speckle tracking echocardiography (2D‐STE) has overcome these limitations and is therefore considered to be superior to TDI in evaluating myocardial function . The main aim of the present study was to evaluate the ability of 2D‐STE and TDI besides the conventional echocardiography for up detecting cardiac dysfunction in children with mild to moderate bronchial asthma.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of cardiac function in pediatric patients with mild to moderate bronchial asthma in the era of cardiac strain imaging

Abdelmohsen

Mohamed

Mohsen

et al. 2019

Pediatric Pulmonology

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Objective Bronchial asthma is a common chronic inflammatory airway disease, which may be associated with pulmonary hypertension and cardiac dysfunction. The aim of this study was to evaluate the ability of 2D‐speckle tracking echocardiography (2D‐STE) and tissue doppler imaging (TDI) to detect subtle cardiac dysfunction in pediatric patients with mild to moderate bronchial asthma. Methodology The study included 30 children with mild to moderate bronchial asthma and 27 age‐matched healthy controls. Both groups underwent pulmonary function tests, TDI and 2D‐STE. Myocardial performance index (MPI), S′, E′, A′ velocities, global strain of left ventricle (LV), right ventricle (RV), and right atrium (RA) were measured. Results RV diastolic function was impaired in the patient group, as the tricuspid E′ velocity was significantly lower in the patients when compared with the controls (16 [14‐17] vs 16 [17‐19] cm/s, P = .044), while the RV‐MPI was significantly higher in patients when compared to controls (0.30 [0.27‐0.36] vs 0.30 [0.30‐0.30], P = .001). The global RV longitudinal strain, RA strain, and LV strain did not show significant differences between the test and the control groups. RV systolic parameters and LV systolic and diastolic parameters did not differ significantly between the two groups. Conclusion Pediatric patients with mild to moderate bronchial asthma may have early RV diastolic dysfunction with preserved other cardiac functions.

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“…Myocardial performance index (MPI) (Tei index) was also measured for both LV and RV. MPI = (ICT+IRT)/ET while ICT is isovolumic contraction time, IRT is isovolumetric relaxation time, ET is ejection time 8 …”

Section: Methodsmentioning

confidence: 99%

Functional recovery of cardiomyopathy induced by atrial tachycardia in children: Insight from cardiac strain imaging

Dohain

Lotfy

Abdelmohsen

et al. 2021

Pacing Clinical Electrophis

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Aim To evaluate systolic and diastolic cardiac function in children who had cardiomyopathy induced by ectopic atrial tachycardia (EAT). Methods Twenty‐two pediatric patients who had cardiomyopathy induced by EAT and 25 age‐matched controls were recruited in this case‐control study. The patients were examined after rhythm control and normalization of their left ventricular systolic function. Different echocardiographic modalities including tissue Doppler imaging and two‐dimension speckle tracking echocardiography were utilized to assess the ventricular and atrial function. Results The patients’ median age was 51 months (interquartile range: 28.5–84 months). The median time interval required for normalization of left ventricular ejection fraction (EF) among patients was 1.5 months (interquartile range: 1.5–2.12 months). Compared to controls, patients had a significantly higher median left ventricular myocardial performance index (MPI) at the interventricular septum (0.44 vs. 0.38, p = .001) and left ventricular lateral wall (0.46 vs. 0.32, p = .0001). The median right ventricular MPI of the patients' group was significantly higher when compared to the control group (0.34 vs. 0.26, p = .0001). The median right atrial (RA) reservoir function in patients was significantly reduced compared to controls (30% vs. 36.63%, p = .007). Conclusions Shortly after rhythm normalization and restoration of left ventricular EF, using tissue Doppler imaging and two‐dimension speckle tracking echocardiography, children who had cardiomyopathy induced by EAT continue to have left ventricular diastolic dysfunction, right ventricular dysfunction, and reduced RA reservoir function.

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Forgotten Right Ventricle in Pediatric Dilated Cardiomyopathy

Cited by 19 publications

References 24 publications

Physiology of the Right Ventricle Across the Lifespan

Physiology of the Right Ventricle Across the Lifespan

Evaluation of cardiac function in pediatric patients with mild to moderate bronchial asthma in the era of cardiac strain imaging

Functional recovery of cardiomyopathy induced by atrial tachycardia in children: Insight from cardiac strain imaging

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