Related Experiment Videos
Changes in pulmonary venous flow patterns in patients with ventricular septal defect
1Department of Pediatrics, Nakadori General Hospital, 3-15, Misono-cho, Minami-dori, Akita 010-8577, Japan.
Insights
Ventricular septal defect in young children can alter pulmonary venous (PV) flow patterns. Symptomatic patients show significantly higher PV diastolic flow, suggesting a link to left-to-right shunting.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Physiology
Background:
- Ventricular septal defect (VSD) is a common congenital heart anomaly.
- Altered hemodynamics in VSD can impact pulmonary venous return.
Purpose of the Study:
- To investigate pulmonary venous (PV) flow patterns in infants and young children with VSD.
- To correlate PV flow characteristics with clinical symptoms and hemodynamic parameters.
Main Methods:
- Doppler echocardiography was used to assess PV flow in 26 patients (<3 years old) with VSD.
- Patients were categorized into symptomatic (n=15) and asymptomatic (n=11) groups.
- Comparison was made with normal controls.
Main Results:
- Symptomatic VSD patients exhibited significantly increased peak diastolic PV flow velocity and flow velocity integral.
- Ratios of diastolic to systolic PV flow velocity and integral were significantly higher in symptomatic patients.
- These PV flow abnormalities correlated with elevated left atrial pressure (V wave) and increased left ventricular mass/atrial volume.
Conclusions:
- Abnormal pulmonary venous flow patterns in VSD are associated with significant left-to-right shunting.
- Elevated left atrial pressure (V wave) is a key factor contributing to these altered PV flow dynamics.
Abstract:
We studied pulmonary venous (PV) flow patterns using Doppler echocardiography in 26 patients with ventricular septal defect less than 3 years of age. Fifteen patients had moderate or severe symptoms, and the remaining 11 had no significant symptoms. Peak velocity of PV diastolic flow and flow velocity integral of PV diastolic flow in the symptomatic patients were significantly larger than those in either asymptomatic patients or the normal controls. The ratio of PV diastolic flow velocity to PV systolic flow velocity and the ratio of flow velocity integral of PV diastolic flow to that of PV systolic flow in the symptomatic patients were significantly larger than those in either asymptomatic patients or the normal controls. The ratio of PV diastolic flow velocity to PV systolic flow velocity as well as the ratio of flow velocity integral of PV diastolic flow to that of PV systolic flow correlated with V wave in left atrial or pulmonary capillary wedge pressure and indexes of left ventricular mass and left atrial volume. We conclude that the abnormal pulmonary venous flow patterns in ventricular septal defect might be associated with large left-to-right shunting and left atrial pressure V wave.