title: Early echocardiographic predictor of heart failure in cerebral arteriovenous malformations.
abstract: Neonatal congestive heart failure in cerebral arteriovenous malformations carries a high risk of mortality. Severe heart failure leading to end-organ dysfunction may be a contraindication to early intervention. Although echocardiographic markers of haemodynamic instability exist, an objective echocardiographic predictor of severe heart failure is not available. We present a ratio of antegrade to retrograde flow in the aortic arch that objectively identifies those at the highest risk of mortality. This measurement can be easily obtained and has prognostic value at presentation, before clinical deterioration. Outcomes remain poor even when early intervention is offered, which may reflect irreversible neurological abnormalities.
authors.affiliation: Department of Pediatrics,Division of Cardiology,UT Southwestern Medical Center at Dallas and Children's Medical Center of Dallas,Dallas,Texas,United States of America.
authors.forename: Poonam P
authors.initials: PP
authors.lastname: Thankavel
authors.affiliation: Department of Pediatrics,Division of Cardiology,UT Southwestern Medical Center at Dallas and Children's Medical Center of Dallas,Dallas,Texas,United States of America.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ramaciotti
mesh_terms: D001013:Aorta, Thoracic / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000453:epidemiology*; D007231:Infant, Newborn; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D013781:Texas
keywords: Arteriovenous malformation; congestive heart failure; prognostic marker