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Impact of Interatrial Communication on Left Ventricle Performance in Patients with Significant Post-tricuspid Shunt

Motea E Elhoury1,2, Mohammed Omar Galal3,4, Abdulrahman Almoukirish3

  • 1Department of Paediatric Cardiology, King Fahad Medical City, KSHC, Riyadh, Saudi Arabia. elhourymotea@gmail.com.

Pediatric Cardiology
|December 27, 2015
PubMed

Insights

Interatrial communication (IAC) may benefit infants with post-tricuspid valve shunts (PTS). The presence of IAC in children with PTS is associated with improved left ventricular (LV) performance, as indicated by echocardiographic and biomarker data.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Echocardiography

Background:

  • Infants with post-tricuspid valve shunts (PTS) represent a population that may benefit from interventions to improve cardiac function.
  • Interatrial communication (IAC) is a potential strategy to augment left ventricular (LV) filling and output in certain pediatric cardiac conditions.

Purpose of the Study:

  • To investigate the impact of interatrial communication (IAC) on left ventricular (LV) performance in infants with post-tricuspid valve shunts (PTS).
  • To compare echocardiographic parameters and cardiac biomarkers between patients with PTS with and without IAC.

Main Methods:

  • Prospective documentation of IAC in 55 infants with PTS.
  • Comprehensive echocardiographic assessment including LV dimensions, mitral inflow Doppler, and tissue Doppler velocities.
  • Measurement of cardiac biomarkers: Creatinine kinase (CK), CKMB, troponin-I, and NT pro-brain natriuretic peptide (NT pro-BNP).

Main Results:

  • Infants with PTS and IAC (Group B) demonstrated smaller LV dimensions and annulus compared to those with PTS without IAC (Group A).
  • Tissue Doppler imaging revealed significantly better systolic and diastolic LV function (higher E' and S' waves) in Group B compared to Group A.
  • Elevated NT pro-BNP levels were observed in patients without IAC (Groups A and C), suggesting increased cardiac strain.

Conclusions:

  • The presence of interatrial communication (IAC) appears to be beneficial for left ventricular (LV) performance in infants with post-tricuspid valve shunts (PTS).
  • Echocardiographic parameters and cardiac biomarkers indicate improved systolic and diastolic LV function in the presence of IAC in this patient cohort.

Keywords:
Left ventricular performanceN-terminal pro-brain natriuretic peptide (NT pro-BNP)Patent ductus arteriosusVentricular septal defect

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