Imperial College London

DrSonyaBabu-Narayan

Faculty of MedicineNational Heart & Lung Institute

Reader in Adult Congenital Heart Disease
 
 
 
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Contact

 

+44 (0)20 7351 8803s.babu-narayan

 
 
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Location

 

NIHR Cardiovascular Biomedical RChelsea WingRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Cordina:2018:10.1016/j.ijcard.2018.02.045,
author = {Cordina, R and Ministeri, M and Babu-Narayan, SV and Ladouceur, M and Celermajer, DS and Gatzoulis, MA and Uebing, A and Li, W},
doi = {10.1016/j.ijcard.2018.02.045},
journal = {INTERNATIONAL JOURNAL OF CARDIOLOGY},
pages = {71--75},
title = {Evaluation of the relationship between ventricular end-diastolic pressure and echocardiographic measures of diastolic function in adults with a Fontan circulation},
url = {http://dx.doi.org/10.1016/j.ijcard.2018.02.045},
volume = {259},
year = {2018}
}

RIS format (EndNote, RefMan)

TY  - JOUR
AB - BackgroundEchocardiographic assessment of diastolic function in the setting of Fontan physiology is not well validated. We recently demonstrated that atrioventricular systolic to diastolic duration ratio (AVV S/D ratio) independently predicts mortality in Fontan-adults and that a value >1.1 was associated with poor prognosis.PurposeTo correlate echocardiographic measures of diastolic function with direct measurement of ventricular end-diastolic pressure (VEDP).MethodsA retrospective analysis was undertaken of Fontan-adults who had transthoracic echocardiography (TTE) within 12months of direct measurement of VEDP during cardiac catheterisation.ResultsFifteen Fontan adults (3 males, mean age 29±9years) were evaluated. Thirteen patients had dominant morphologic left ventricle and 2 had morphologic right ventricle. Four had atriopulmonary connection and 11 had total cavopulmonary connection. Twelve patients were NYHA Class I/II and 3 were Class III. Time between TTE and cardiac catheter was 46±113days; VEDP was 8±5mmHg. Ten patients had preserved ventricular function, 3 had mild and 2 had moderate systolic impairment by subjective TTE assessment. AVV S/D ratio had the strongest correlation with VEDP (r=0.8, p=0.001). AVV S/D ratio≥1.1 had 100% positive predictive value and 92% negative predictive value for detecting VEDP >10mmHg. The only conventional echocardiographic measure of diastolic function that correlated with VEDP was pulmonary vein A wave - atrioventricular A wave duration difference (r=0.8, p=0.02).ConclusionsTTE measures reflect VEDP in adults with a Fontan circulation. AVV S/D ratio is a simple parameter yet to enter standard practice that can be used to identify elevated VEDP.
AU - Cordina,R
AU - Ministeri,M
AU - Babu-Narayan,SV
AU - Ladouceur,M
AU - Celermajer,DS
AU - Gatzoulis,MA
AU - Uebing,A
AU - Li,W
DO - 10.1016/j.ijcard.2018.02.045
EP - 75
PY - 2018///
SN - 0167-5273
SP - 71
TI - Evaluation of the relationship between ventricular end-diastolic pressure and echocardiographic measures of diastolic function in adults with a Fontan circulation
T2 - INTERNATIONAL JOURNAL OF CARDIOLOGY
UR - http://dx.doi.org/10.1016/j.ijcard.2018.02.045
UR - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000428300900018&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR - http://hdl.handle.net/10044/1/61480
VL - 259
ER -