title: Impact of Interatrial Communication on Left Ventricle Performance in Patients with Significant Post-tricuspid Shunt.
abstract: Infants with post-tricuspid valve shunts (PTS) may benefit from interatrial communication (IAC). The effect of IAC on left ventricular (LV) performance in these patients was studied. IAC was documented prospectively in 55 patients with PTS. Clinical status, echocardiographic dimensions of LV, mitral inflow Doppler, tissue Doppler velocities and time intervals were measured. Creatinine kinase (CK), CKMB, troponin-I and NT pro-brain natriuretic peptide (NT pro-BNP) were measured. Patients were divided into four groups: (A) PTS but no IAC (n = 32); (B) PTS and IAC (n = 23); (C) VSD but no IAC (n = 16); and (D) VSD and IAC (n = 19). Group A had more frequent mitral regurgitation (p = 0.041), larger mitral annulus (1.80 vs. 1.30 cm, p < 0.0001) and larger LV systolic and diastolic dimensions (2.01 vs. 1.40 and 3.28 vs. 2.35 cm, p < 0.001) than group B. The E-wave deceleration time tended to be longer in group A (121.0 vs. 106.8 ms, p = 0.06). By tissue Doppler, group A had E'- and S-waves significantly taller (15.51 vs. 13.14 and 7.69 vs. 6.72 cm, p = 0.04 and p = 0.005, respectively) than group B. Also, NT pro-BNP was significantly higher in group A (1116.15 vs. 458.73 pg/ml, p = 0.028). Group C had significant larger mitral z-score values (1.2 vs. 0.01, p < 0.001), larger LV diameter z-score (p = 0.001) and higher NT pro-BNP level (1477.37 vs. 451.66 pg/ml, p = 0.001) than group D. There was no significant difference in the clinical status between the groups. In children with PTS, the presence of IAC could be beneficial. Their echocardiographic parameters and biomarker show better systolic and diastolic LV performance.
authors.affiliation: Department of Paediatric Cardiology, King Fahad Medical City, KSHC, Riyadh, Saudi Arabia. elhourymotea@gmail.com.|Cardiac Services, Armed Force Hospital Southern Region, P. O. Box: 101, Khamis Mushayt, 61961, Saudi Arabia. elhourymotea@gmail.com.
authors.forename: Motea E
authors.initials: ME
authors.lastname: Elhoury
authors.affiliation: Department of Paediatric Cardiology, King Fahad Medical City, KSHC, Riyadh, Saudi Arabia.|Department of Paediatric Cardiology, Essen University, Essen, Germany.
authors.forename: Mohammed Omar
authors.initials: MO
authors.lastname: Galal
authors.affiliation: Department of Paediatric Cardiology, King Fahad Medical City, KSHC, Riyadh, Saudi Arabia.
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Almoukirish
authors.affiliation: Department of Community Medicine, Faculty of Medicine, King Fahad Medical City, KSAU-HS, Riyadh, Saudi Arabia.
authors.forename: Abdalla
authors.initials: A
authors.lastname: Saeed
authors.affiliation: Department of Paediatric Cardiology, King Fahad Medical City, KSHC, Riyadh, Saudi Arabia.|Department of Paediatric Cardiology, Skåne University Hospital, Lund, Sweden.
authors.forename: Milad
authors.initials: M
authors.lastname: El-Segaier
mesh_terms: D015415:Biomarkers / Q000097:blood; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging*; D015150:Echocardiography, Doppler; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D008943:Mitral Valve / Q000503:physiopathology*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging*; D009200:Myocardial Contraction; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D012372:ROC Curve; D014261:Tricuspid Valve / Q000503:physiopathology*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Left ventricular performance; N-terminal pro-brain natriuretic peptide (NT pro-BNP); Patent ductus arteriosus; Ventricular septal defect