Pathophysiology of coronary blood flow in congenital heart disease

Aburawi, Elhadi H.; Pesonen, Erkki

doi:10.1016/j.ijcard.2010.05.048

Cited by 11 publications

(6 citation statements)

References 26 publications

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“…In newborns, increased coronary perfusion pressure seems to be the most important factor for increased CF, even if the pressure is not assumed to cause a significant increase in flow over the auto-regulatory range of 70–130 mm Hg. We also showed that inflammation decreases CF [24] .…”

Section: Pathophysiology Of Coronary Blood Flow In Congenital Heart Dsupporting

confidence: 60%

A welcome to the new journal, International Journal of Cardiology — Heart and Vessels (IJC-H + V)

Shewan

Coats

2013

IJC Heart & Vessels

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A new journal has been launched: IJC — Heart and Vessels [1]. It builds upon the success of the main journal International Journal of Cardiology. As an introduction to the new journal we will be publishing a series of summaries of the topics to be covered, highlighting the most important papers in the field that have been published recently in the main journal, International Journal of Cardiology. This article describes a topic review of congenital heart disease. IJC has become one of the most important sources of quality papers in this field and many excellent publications have been published in the main journal. The expansion of space occasioned by the launch of IJC — Heart and Vessels will allow us to publish more high quality papers in the expanding field of congenital heart disease.

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Section: Pathophysiology Of Coronary Blood Flow In Congenital Heart Dsupporting

confidence: 60%

A welcome to the new journal, International Journal of Cardiology — Heart and Vessels (IJC-H + V)

Shewan

Coats

2013

IJC Heart & Vessels

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“…Myocardial function and output are usually impaired in congenital heart disease, but may become more so after surgery. Coronary flow increases after cardiopulmonary bypass surgery [1,2]. In adults, impaired myocardial repolarization and increased risk of arrhythmia are well known consequences of open heart surgery [3].…”

Section: Introductionmentioning

confidence: 99%

Early changes in myocardial repolarization and coronary perfusion after cardiopulmonary bypass surgery for ASD repair in children

Aburawi

Souid

Liuba

et al. 2013

BMC Cardiovasc Disord

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BackgroundIn adults, impaired myocardial repolarization and increased risk of arrhythmia are known consequences of open heart surgery. Little is known, however, about post-operative consequences of cardiopulmonary bypass surgery in children. The aim of this study was to assess ventricular repolarization and coronary perfusion after bypass surgery for atrial septal defect (ASD) repair in children.MethodsTwelve patients with ASD were assessed one day before and 5–6 days after ASD repair. Myocardial repolarization (corrected QT interval, QTc, QT dispersion, QTd, and PQ interval) was determined on 12-lead electrocardiograms. Coronary flow in proximal left anterior descending artery (peak flow velocity in diastole, PFVd) was assessed by transthoracic Doppler echocardiography.ResultsTen of the 12 (83%) children had normal myocardial repolarization before and after surgery. After surgery, QTc increased 1-9% in 5 (42%) patients, decreased 2-11% in 5 (42%) patients and did not change in 2 (16%) patients. Post-op QTc positively correlated with bypass time (R=0.686, p=0.014) and changes in PFVd (R=0.741, p=0.006). After surgery, QTd increased 33-67% in 4 (33%) patients, decreased 25-50% in 6 patients (50%) and did not change in 2 (16%) patients. After surgery, PQ interval increased 5-30% in 4 (33%) patients, decreased 4-29% in 6 (50%) patients and did not change in 1 (8%) patient. Post-op PQ positively correlated with bypass time (R=0.636, p=0.027). As previously reported, PFVd significantly increased after surgery (p<0.001).ConclusionsChanges in QTc, PQ and PFVd are common in young children undergoing surgery for ASD repair. Post-op QTc significantly correlates with bypass time, suggesting prolonged cardiopulmonary bypass may impair ventricular repolarization. Post-op QTc significantly correlates with PFVd changes, suggesting increased coronary flow may also impair ventricular repolarization. The clinical significance and reversibility of these alternations require further investigations.

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“…Basal coronary flow has been shown to increase in patients with shunt lesions, such as ventricular septal defects, atrioventricular septal defects and atrial septal defects . In patients with coarctation of the aorta, increased preductal blood pressure, myocardial strain and ventricular hypertrophy seemed to have a maximal increasing effect on coronary blood flow .…”

Section: Resultsmentioning

confidence: 98%

Review findings included diminished coronary flow reserve after surgery in children with congenital heart disease and inflammation

2018

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Aim: The aim of this review was to develop a deeper knowledge of the physiology of coronary blood flow and coronary flow reserve in young patients with congenital heart disease and inflammatory diseases. Methods: We searched for papers published in English on coronary blood flow and coronary flow reserve using the PubMed and Google search databases. This identified 42 papers extending back to 1976 and a book from 2008 (Davis et al. Microcirculation. Boston, MA: Elsevier, 2008: 161-284).Results: Our review showed that the implications of coronary blood flow and coronary flow reserve in paediatric patients with congenital heart disease and inflammatory diseases are still not fully understood. However, a key finding was that coronary flow reserve was diminished in patients with congenital heart disease and inflammation after surgery, with or without a cardiopulmonary bypass. Other findings discussed by this review relate to volume and pressure overload in acyanotic congenital heart disease, reduced myocardial perfusion and cyanotic congenital heart disease. Conclusion:We still have much to discover about paediatric patients with congenital heart disease and inflammatory diseases. Understanding the pathophysiology of coronary blood flow could help the postoperative treatment of such patients.

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Pathophysiology of coronary blood flow in congenital heart disease

Abstract: Objectives: The aim was to investigate the effects of volume and pressure overload and increased coronary perfusion pressure on coronary flow (CF) in congenital heart disease (CHD) patients.Background: The effects of CHD on CF are poorly mapped.

Cited by 11 publications

References 26 publications

A welcome to the new journal, International Journal of Cardiology — Heart and Vessels (IJC-H + V)

A welcome to the new journal, International Journal of Cardiology — Heart and Vessels (IJC-H + V)

Early changes in myocardial repolarization and coronary perfusion after cardiopulmonary bypass surgery for ASD repair in children

Review findings included diminished coronary flow reserve after surgery in children with congenital heart disease and inflammation

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