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The relationship between left ventricular dilation and right ventricular diastolic function in children with a patent

Cole Miller1, William Anderson2, Joseph A Paolillo3

  • 1Division of Pediatric Cardiology, Children's Hospital of Atlanta, Atlanta, GA, USA.

Annals of Pediatric Cardiology
|June 8, 2023
PubMed

Insights

In children with a patent ductus arteriosus (PDA), left ventricular (LV) dilation did not impact right ventricular (RV) end-diastolic pressure (RVEDP). RVEDP was instead linked to RV systolic pressure.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Physiology
  • Echocardiography

Background:

  • Ventricular-ventricular interaction is crucial in cardiovascular health.
  • The effect of left ventricular (LV) dilation on right ventricular (RV) diastolic function in pediatric patent ductus arteriosus (PDA) remains understudied.
  • Understanding these interactions is key for managing complex congenital heart conditions.

Purpose of the Study:

  • To investigate the impact of LV dilation on RV diastolic function in pediatric patients with PDA.
  • To test the hypothesis that LV dilation elevates RV end-diastolic pressure (RVEDP) via ventricular-ventricular interaction in PDA patients.

Main Methods:

  • Retrospective analysis of 113 pediatric patients (6 months–18 years) undergoing transcatheter PDA closure (2010-2019).
  • Evaluation of RVEDP, LV end-diastolic dimension Z-score (LVEDD Z-score), RV systolic pressure, pulmonary artery/aortic systolic pressure ratio, and pulmonary capillary wedge pressure.
  • Statistical analysis to determine associations between variables.

Main Results:

  • RVEDP showed a positive association with RV systolic pressure (P < 0.01), pulmonary artery/aortic systolic pressure ratio (P < 0.01), and pulmonary capillary wedge pressure (P < 0.01).
  • No significant association was found between RVEDP and LVEDD Z-score (P = 0.74), indicating LV dilation did not directly affect RVEDP.
  • The median LVEDD Z-score was 1.6, suggesting LV dilation was present in the cohort.

Conclusions:

  • In pediatric patients with PDA, RVEDP is not significantly associated with LV dilation.
  • RVEDP is primarily influenced by RV systolic pressure and pulmonary pressures in this population.
  • Findings suggest that ventricular-ventricular interaction through LV dilation may not be a primary driver of RV diastolic dysfunction in PDA.

Keywords:
End-diastolic pressurehemodynamicspatent ductus arteriosusright ventricular function

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