Multidimensional evaluation of cardiac hemodynamics and electrophysiology in patients with congenital and acquired heart disease

Kamphuis, V.P. (2019)

Doctoral Thesis

This thesis provides insight in the impact of congenital and acquired heart diseases on electrophysiology and hemodynamics in the heart, that could help understand the often complex pathophysiological mechanisms involved in cardiovascular diseases and might aid in the early detection of patients prone to cardiovascular deterioration. 

The first part of this thesis shows the value of the electrocardiogram and vectorcardiogram in the assessment of patients with right-sided acquired and congenital heart defects. The 3D vectorcardiographic VG and SA could be valuable in the assessment of patients with right ventricular volume or pressure overload. 

The second part of this thesis shows significant steps towards clinical utility of 4D flow MRI. Valvular flow quantification with 4D flow MRI, especially in combination with automated valve tracking, has great potential as a future clinical standard. 

The third part of this thesis provides important insights in intraventricular hemodynamics in Fontan patients. In time to come, knowledge on intraventricular hemodynamics could aid in determining follow-up frequency and the ideal timing of initiation of heart failure management, perhaps even on an individual patient’s level. Moreover, these findings can create a platform for further research in the field of intraventricular hemodynamics in healthy subjects and different patient groups.

• Electrocardiography
• Vectorcardiography
• Congenital heart defect
• MRI
• Hemodynamics
• Fontan
• Flow
• Valvular flow
• 4D flow MRI

• All authors: Kamphuis, V.P.
• Supervisor: Blom, N.A.; Helbing, W.A.
• Co-supervisor: Roest, A.A.W.
• Committee: Schalij, M.J.; Mulder-van der Wall, B.J.M.; Carlsson, M.; Planken, R.N.
• Qualification: Doctor (dr.)
• Awarding Institution: Kindergeneeskunde, divisie Kindercardiologie, Medicine / Leiden University Medical Center (LUMC), Leiden University
• Date: 2019-01-31
• ISBN (print): 9789463234627
• Sponsorship: The research described in this thesis was supported by a grant of the Dutch Heart Foundation (DHF grant number 2013T091).