PMID- 23850317
OWN - NLM
STAT- MEDLINE
DCOM- 20140626
LR  - 20141120
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 168
IP  - 4
DP  - 2013 Oct 9
TI  - Hemodynamics of patients developing pulmonary arterial hypertension after shunt 
      closure.
PG  - 3797-801
LID - S0167-5273(13)01090-5 [pii]
LID - 10.1016/j.ijcard.2013.06.036 [doi]
AB  - BACKGROUND: Pulmonary arterial hypertension (PAH) after shunt closure is 
      associated with a poor prognosis. The aim of this study was to assess 
      retrospectively the hemodynamics of patients developing PAH after shunt closure. 
      METHODS: Hemodynamic data obtained by right heart catheterization (RHC) performed 
      at baseline and after shunt closure were analyzed. RESULTS: Twenty-two patients, 
      13 with atrial septal defect (ASD), 6 with ventricular septal defect (VSD), 1 
      with patent ductus arteriosus, 1 with both ASD and VSD, and 1 with complete 
      atrio-ventricular canal have been considered. The mean age at closure was 
      25.3+/-20.1 years (range of 3 months to 56.7 years), and the mean age at PAH 
      diagnosis was 37.0+/-20.8 years (range of 5 to 61.2 years). The time delay between 
      shunt closure and PAH diagnosis was 140.2+/-100.2 months. At baseline RHC, 
      hemodynamic data were as follows: pulmonary vascular resistance (PVR) of 8.6+/-2.6 
      Wood units, PVR index (PVRi) of 10.1+/-2.7 Wood units *m(2), mean pulmonary arterial 
      pressure of 43.7+/-9.7 mmHg, PVR to systemic vascular resistance ratio (PVR/SVR) of 
      0.70+/-0.23, and Qp/Qs of 1.6+/-0.4. In particular, 18/22 (81%) had PVR>/=5 Wood units, 
      21/22 (95%) PVRi>/=6 Wood units *m(2), 21/22 (95%) PVR/SVR>/=0.33, and 11/22 (50%) 
      Qp/Qs</=1.5. During the follow-up, 5/22 (22%) patients died and one patient 
      underwent successful double lung transplantation. CONCLUSIONS: High baseline 
      values of PVR (>/=5 Wood units), PVRi (>/=6 Wood units *m(2)) and PVR/SVR (>/=0.33) are 
      common findings in patients who develop PAH late after shunt closure. Large 
      prospective clinical trials are needed to establish the safe limits for shunt 
      closure.
CI  - (c) 2013.
FAU - D'Alto, Michele
AU  - D'Alto M
AD  - Department of Cardiology, Second University of Naples, Monaldi Hospital, Naples, 
      Italy. Electronic address: mic.dalto@tin.it.
FAU - Romeo, Emanuele
AU  - Romeo E
FAU - Argiento, Paola
AU  - Argiento P
FAU - Correra, Anna
AU  - Correra A
FAU - Santoro, Giuseppe
AU  - Santoro G
FAU - Gaio, Gianpiero
AU  - Gaio G
FAU - Sarubbi, Berardo
AU  - Sarubbi B
FAU - Calabro, Raffaele
AU  - Calabro R
FAU - Russo, Maria Giovanna
AU  - Russo MG
LA  - eng
PT  - Journal Article
DEP - 20130711
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cardiac Catheterization/*adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Familial Primary Pulmonary Hypertension
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Defects, Congenital/epidemiology/*physiopathology/*surgery
MH  - Hemodynamics/*physiology
MH  - Humans
MH  - Hypertension, Pulmonary/diagnosis/epidemiology/*physiopathology
MH  - Infant
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/diagnosis/epidemiology/*physiopathology
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Congenital heart diseases
OT  - Hemodynamics
OT  - Pulmonary hypertension
EDAT- 2013/07/16 06:00
MHDA- 2014/06/27 06:00
CRDT- 2013/07/16 06:00
PHST- 2013/03/03 00:00 [received]
PHST- 2013/05/08 00:00 [revised]
PHST- 2013/06/20 00:00 [accepted]
PHST- 2013/07/16 06:00 [entrez]
PHST- 2013/07/16 06:00 [pubmed]
PHST- 2014/06/27 06:00 [medline]
AID - S0167-5273(13)01090-5 [pii]
AID - 10.1016/j.ijcard.2013.06.036 [doi]
PST - ppublish
SO  - Int J Cardiol. 2013 Oct 9;168(4):3797-801. doi: 10.1016/j.ijcard.2013.06.036. 
      Epub 2013 Jul 11.