PMID- 25972285
OWN - NLM
STAT- MEDLINE
DCOM- 20160617
LR  - 20200206
IS  - 1432-1971 (Electronic)
IS  - 0172-0643 (Print)
IS  - 0172-0643 (Linking)
VI  - 36
IP  - 7
DP  - 2015 Oct
TI  - Left Ventricular Remodeling and Function in Children with Biventricular 
      Circulation After Fetal Aortic Valvuloplasty.
PG  - 1502-9
LID - 10.1007/s00246-015-1193-6 [doi]
AB  - Fetal aortic valvuloplasty (FAV) has shown promise in averting the progression of 
      fetal aortic stenosis to hypoplastic left-heart syndrome. Altered loading 
      conditions due to valvar disease, intrinsic endomyocardial abnormalities, and 
      procedures that alter endomyocardial mechanics may place patients with 
      biventricular circulation (BiV) after FAV at risk of abnormal LV remodeling and 
      function. Using the most recent echo data on BiV patients after technically 
      successful FAV (n = 34), we evaluated LV remodeling pattern, risk factors for 
      pathologic LV remodeling, and the association between LV remodeling pattern and 
      LV function. Median age at follow-up was 4.7 years (range 1.0-12.5). Cardiac 
      interventions were common. At latest follow-up, no patient had hypoplastic LV. 
      Nineteen patients (55 %) had dilated LV, and five (16 %) patients had severely 
      dilated LV. LV remodeling patterns were as follows: 12 (35 %) normal ventricle, 
      11 (32 %) mixed hypertrophy, 8 (24 %) eccentric hypertrophy or remodeling, and 3 
      (9 %) concentric hypertrophy. Univariate factors associated with pathologic LV 
      remodeling were long-standing AR, >/=2 cardiac interventions, EFE resection, and 
      aortic or mitral regurgitation >/= moderate at most recent follow-up. In 
      multivariate analysis, only long-standing AR fraction remained associated with 
      pathologic remodeling. Pathologic LV remodeling was associated with depressed 
      ejection fraction, lower septal E , and higher E/E . Pathologic LV remodeling, 
      primarily eccentric or mixed hypertrophy, is common in BiV patients after FAV and 
      is related to LV loading conditions imposed by valvar disease. Pathologic 
      remodeling is associated with both systolic and diastolic dysfunction in this 
      population.
FAU - Friedman, Kevin G
AU  - Friedman KG
AD  - Department of Cardiology, Children's Hospital Boston, Boston, MA, 02115, USA. 
      Kevin.Friedman@cardio.chboston.org.
AD  - Department of Pediatrics, Harvard Medical School, Boston, MA, USA. 
      Kevin.Friedman@cardio.chboston.org.
FAU - Freud, Lindsay
AU  - Freud L
AD  - Department of Cardiology, Children's Hospital Boston, Boston, MA, 02115, USA.
AD  - Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
FAU - Escobar-Diaz, Maria
AU  - Escobar-Diaz M
AD  - Department of Cardiology, Children's Hospital Boston, Boston, MA, 02115, USA.
AD  - Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
FAU - Banka, Puja
AU  - Banka P
AD  - Department of Cardiology, Children's Hospital Boston, Boston, MA, 02115, USA.
AD  - Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
FAU - Emani, Sitaram
AU  - Emani S
AD  - Department of Cardiology, Children's Hospital Boston, Boston, MA, 02115, USA.
AD  - Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
FAU - Tworetzky, Wayne
AU  - Tworetzky W
AD  - Department of Cardiology, Children's Hospital Boston, Boston, MA, 02115, USA.
AD  - Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
LA  - eng
GR  - T32 HL007572/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20150515
PL  - United States
TA  - Pediatr Cardiol
JT  - Pediatric cardiology
JID - 8003849
SB  - IM
MH  - Aortic Valve/diagnostic imaging
MH  - Aortic Valve Stenosis/*diagnostic imaging
MH  - Cardiac Surgical Procedures/*adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Diastole/physiology
MH  - Echocardiography, Doppler
MH  - Female
MH  - Heart Ventricles/physiopathology
MH  - Humans
MH  - Hypoplastic Left Heart Syndrome/*surgery
MH  - Infant
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Postoperative Complications/*diagnostic imaging
MH  - Ventricular Dysfunction, Left/*diagnostic imaging
MH  - *Ventricular Remodeling
PMC - PMC7001762
MID - NIHMS1065503
OTO - NOTNLM
OT  - Aortic stenosis
OT  - Diastolic dysfunction
OT  - Fetal cardiology
OT  - Left ventricular remodeling
EDAT- 2015/05/15 06:00
MHDA- 2016/06/18 06:00
PMCR- 2020/02/05
CRDT- 2015/05/15 06:00
PHST- 2014/12/12 00:00 [received]
PHST- 2015/05/06 00:00 [accepted]
PHST- 2015/05/15 06:00 [entrez]
PHST- 2015/05/15 06:00 [pubmed]
PHST- 2016/06/18 06:00 [medline]
PHST- 2020/02/05 00:00 [pmc-release]
AID - 10.1007/s00246-015-1193-6 [pii]
AID - 10.1007/s00246-015-1193-6 [doi]
PST - ppublish
SO  - Pediatr Cardiol. 2015 Oct;36(7):1502-9. doi: 10.1007/s00246-015-1193-6. Epub 2015 
      May 15.