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Henkens, I.R. (2008)

Non-invasive diagnosis and follow-up of right ventricular overload

Doctoral Thesis
Right ventricular overload covers a spectrum ranging from volume overload to pressure overload, and often is a combination of these, compromising cardiac function. Part I focuses on right ventricular volume overload in adults with Fallot__s tetralogy corrected in early childhood. We determined which patient characteristics are associated with a more prompt recovery time after surgical pulmonary valve replacement. Furthermore, we analyzed what may be expected from pulmonary valve replacement with respect to right ventricular reverse remodeling. We also determined that pulmonary valve replacement has a positive effect on myocardial repolarization characteristics in adult Fallot patients. Part II addresses right ventricular pressure overload due to pulmonary arterial hypertension. Development of pulmonary arterial hypertension in rats induced characteristic evolutionary changes in right ventricular morphology and function, as monitored with electrocardiography, echocardiography, and...Show moreRight ventricular overload covers a spectrum ranging from volume overload to pressure overload, and often is a combination of these, compromising cardiac function. Part I focuses on right ventricular volume overload in adults with Fallot__s tetralogy corrected in early childhood. We determined which patient characteristics are associated with a more prompt recovery time after surgical pulmonary valve replacement. Furthermore, we analyzed what may be expected from pulmonary valve replacement with respect to right ventricular reverse remodeling. We also determined that pulmonary valve replacement has a positive effect on myocardial repolarization characteristics in adult Fallot patients. Part II addresses right ventricular pressure overload due to pulmonary arterial hypertension. Development of pulmonary arterial hypertension in rats induced characteristic evolutionary changes in right ventricular morphology and function, as monitored with electrocardiography, echocardiography, and heart catheterization. The documented evolutionary electrocardiographic changes in evolving right ventricular pressure overload in rats were similar to the abnormalities found in patients with varying degrees of pulmonary arterial hypertension. Electrocardiographic cut-off points can be useful for monitoring treatment response in pulmonary arterial hypertension patients. Finally, resting heart rate, reflecting hemodynamics and neurohumoral activation, is an important prognosticator in pulmonary arterial hypertension, and should be addressed at frequent intervals.Show less
Cardiac magnetic resonance imaging
Electrocardiography
Heart rate
Monocrotalin
Pulmonary hypertension
Pulmonary valve
Right ventricular overload
Surgical valve replacement
Tetralogy of Fallot
All authors
Henkens, I.R.
Supervisor
Wall, E.E. van der; Schalij, M.J.
Co-supervisor
Vliegen, H.W.
Qualification
Doctor (dr.)
Awarding Institution
Leiden University Medical Center (LUMC), Leiden University
Date
2008-11-20
ISBN (print)
9789071382666

Funding

Sponsorship
Leiden University Medical Center Library Leiden University Medical Center, dept. of Cardiology