Diastolic and Systolic Cardiac Dysfunction in Pectus Excavatum: Relationship to Exercise and Malformation Severity

Area of Science:

• Cardiology
• Thoracic Surgery
• Diagnostic Imaging

Background:

• Pectus excavatum (PEX) is a congenital chest wall malformation.
• Cardiac function can be affected in patients with PEX.
• Stress echocardiography is a valuable tool for assessing cardiac function under exertion.

Purpose of the Study:

• To investigate stress echocardiographic findings in patients with PEX.
• To correlate these findings with the severity of the PEX malformation.
• To identify potential cardiac complications associated with PEX.

Main Methods:

• A prospective registry of consecutive patients diagnosed with isolated PEX was established.
• Patients underwent chest CT for malformation index evaluation and stress echocardiography.
• Comparison was made with a control group of healthy volunteers.

Main Results:

• Patients with PEX demonstrated lower maximal workload and impaired right ventricular systolic and diastolic function compared to controls.
• Tricuspid area increment during exercise was significantly reduced in PEX patients.
• Abnormalities in right ventricular function during stress were associated with PEX malformation severity.

Conclusions:

• PEX is associated with adverse functional and morphological cardiac changes, particularly affecting right ventricular function.
• These cardiac manifestations, including diastolic and systolic dysfunction, are exacerbated during stress.
• The severity of cardiac involvement in PEX correlates with the degree of chest wall malformation.