Related Experiment Video

Updated: Aug 4, 2025

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
07:11

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography

Published on: October 28, 2020

2.9K

Ventricular function and biomarkers in relation to repair and pulmonary valve replacement for tetralogy of Fallot

Jelle P G van der Ven1,2, Marie Günthel3, Eva van den Bosch1,2

  • 1Netherlands Heart Institute, Utrecht, The Netherlands.

Open Heart
|April 6, 2023
PubMed

Insights

Cardiac surgery for tetralogy of Fallot (ToF) repair or pulmonary valve replacement (PVR) causes temporary changes in ventricular function. Specific immune responses are observed, but factors for advantageous recovery remain unidentified.

Area of Science:

  • Cardiology
  • Pediatric Cardiac Surgery
  • Immunology

Background:

  • Cardiac surgery can lead to temporary myocardial injury and impaired ventricular performance.
  • Tetralogy of Fallot (ToF) repair and pulmonary valve replacement (PVR) are common cardiac surgeries in children.
  • Understanding the perioperative response is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To characterize the functional and immunological response to perioperative injury in pediatric patients undergoing ToF repair or PVR.
  • To identify potential biomarkers and molecular changes associated with surgical recovery.
  • To investigate differences in response between ToF repair and PVR procedures.

Main Methods:

  • Prospective observational study involving 45 patients with ToF repair and 16 patients with PVR.
  • Echocardiography (speckle tracking) and serum biomarker analysis performed preoperatively, early postoperatively, and at 1-year follow-up.
  • RNA sequencing of right ventricular outflow tract samples to assess tissue gene expression.

Main Results:

  • Left and right ventricular global longitudinal strain showed a transient fall-and-rise pattern after ToF repair, but not after PVR.
  • Serum biomarkers clustered into three principal components related to surgery type, ToF status, and postoperative status, with increased scores post-surgery.
  • RV outflow tract transcriptome was primarily associated with patient sex, not ToF-related phenotypes.

Conclusions:

  • The response to perioperative injury in ToF repair and PVR is distinct, involving specific functional and immunological changes.
  • While patterns of ventricular dysfunction and biomarker changes were observed, factors influencing advantageous recovery were not identified.
  • Further research is needed to elucidate mechanisms of recovery and identify predictive factors for optimal outcomes.
Abstract

Keywords:
biomarkerscardiopulmonary bypassechocardiographypulmonary valve insufficiencytetralogy of Fallot

More Related Videos

Assessment of Right Ventricular Structure and Function in Mouse Model of Pulmonary Artery Constriction by Transthoracic Echocardiography10:33

Assessment of Right Ventricular Structure and Function in Mouse Model of Pulmonary Artery Constriction by Transthoracic Echocardiography

Published on: February 3, 2014

27.8K
Biventricular Assessment of Cardiac Function and Pressure-Volume Loops by Closed-Chest Catheterization in Mice08:21

Biventricular Assessment of Cardiac Function and Pressure-Volume Loops by Closed-Chest Catheterization in Mice

Published on: June 15, 2020

4.3K

Related Concept Videos

Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
14
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
19
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
20
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
27
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
28
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
22