The cardiac blood supply–workload balance in children

Abstract

It is well known that the reflected pressure wave in small children returns earlier than that in adolescent. The reason of early return of the reflected pressure wave in infancy is their height.The short distance between heart and reflection point makes the reflected pressure wave returning to the heart earlier. In adult, the early return (during systole) of the reflected pressure wave means disadvantage to cardiac blood supply-workload balance. The purpose of this study is to clarify whether the early return of the reflected pressure wave in small children impairs the cardiac blood supply-workload balance.This study enrolled 37 small left to right shunt patients with normal aortic circulation below 15 years of age. The aortic pressure waveform was recorded using a pressure sensor mounted catheter, and augmentation index and subendocardial viability ratio were calculated.The age of patients was 6.1 ± 3.2 years old. The augmentation index was 8.7 ± 14.3 % and the index had a negative correlation with patients' age (r = -0.6243, p<0.0001). The subendocardial viability ratio, which means the cardiac blood supply-workload balance, was 0.92 ± 0.14 and the index had a positive relationship with patients' age (r = 0.6435, p<0.0001).The cardiac blood supply-workload balance gradually improves from infancy to young adulthood. And one of the causes of the unfavorable cardiac blood supply -workload balance in infancy would be the accelerated aortic pressure wave reflection due to their short height.

Excess weight in children and adolescents is associated with altered subendocardial blood supply among girls but not boys

“…Moreover, it has been previously reported that lowest SEVR in children was associated with early return of reflected pressure waves. 17 In the present study, cAP was not different between groups and, hence, there is no evidence of shorter wave reflection time among overweight/ obese to explain the differences found. On the other hand, heart rate derived from the pulse wave recording was higher among overweight/obese girls, which caused the time spent with diastole be shorter in this group.…”

Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients

“…Figs 3 and 4 show the agreement between the computed pressure and flow rate and those given in literature for both the systemic and pulmonary circulation. In particular, Fig 3 shows the physiological aortic pressure and flow rate calculated by the 0D model together with published in vivo measurements obtained in paediatric subjects [19,20]. There is a good PLOS ONE [22,23].…”

“…Panel (a): 0D model results for the physiologic case (aortic pressure, red curve; aortic flow rate, blue curve). Panels (b) and (c): published in-vivo data (aortic Doppler velocity waveform[19] and aortic pressure[20]). Note that, by assuming a constant valve area, the velocity waveform resembles the flow one except for the absolute values and the scale.https://doi.org/10.1371/journal.pone.0258225.g003…”

Pulse Wave Velocity, Central Haemodynamic Parameters, and Markers of Kidney Function in Children

“…Other correlating central haemodynamic parameters are partly dependent on the HR, so we are of opinion that their correlation is also a consequence of the physiological state. Murakami et al [19] also showed a positive relationship between SEVR and age in children. Our prediction is supported by the fact that the results of other kidney function markers do not show an association with central haemodynamic parameters.…”

“…Alx is, like PWV, a measure of systemic arterial stiffness derived from the ascending aortic pressure waveform. It is calculated from pulse wave reflection pressures as the augmentation pressure divided by the pulse pressure [18, 19].…”