Gupta Saurabh Kumar, Krishnamoorthy Km, Tharakan Jaganmohan A, Sivasankaran S, Sanjay G, Bijulal S, Anees T
Department of Cardiology, Sree Chitra Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Ann Pediatr Cardiol. 2011 Jul;4(2):139-44. doi: 10.4103/0974-2069.84652.
To evaluate the effect of percutaneous closure of patent ductus arteriosus (PDA) on left ventricular (LV) systolic and diastolic function in children.
Limited studies are available on alteration in LV hemodynamics, especially diastolic function, after PDA closure.
Thirty-two consecutive children with isolated PDA treated by trans-catheter closure were studied. The LV systolic and diastolic function were assessed by two-dimensional (2D) echocardiography and tissue Doppler imaging 1 day before the PDA closure, on day 1, and on follow-up.
At baseline, none of the patients had LV systolic dysfunction. On day 1 post-PDA closure, 8 (25%) children developed LV systolic dysfunction. The baseline LV ejection fraction (LVEF), LV end-systolic dimension (LVESD), and PDA diastolic gradient predicted the post-closure LVEF. Patients who developed post-closure LV systolic dysfunction had poorer LV diastolic function than those who did not. LV diastolic properties improved after PDA closure; however, the improvement in LV diastolic properties lagged behind the improvement in the LV systolic function. All children were asymptomatic and had normal LVEF on follow up of >3 months.
Percutaneous closure of PDA is associated with the reversible LV systolic dysfunction. Improvement in the LV diastolic function lags behind that in the LV systolic function.
评估经皮闭合动脉导管未闭（PDA）对儿童左心室（LV）收缩和舒张功能的影响。
关于PDA闭合后LV血流动力学改变，尤其是舒张功能改变的研究有限。
对32例连续接受经导管闭合治疗的孤立性PDA患儿进行研究。在PDA闭合前1天、第1天及随访时，通过二维（2D）超声心动图和组织多普勒成像评估LV收缩和舒张功能。
基线时，所有患者均无LV收缩功能障碍。PDA闭合后第1天，8例（25%）患儿出现LV收缩功能障碍。基线LV射血分数（LVEF）、LV收缩末期内径（LVESD）和PDA舒张期压差可预测闭合后的LVEF。闭合后出现LV收缩功能障碍的患者比未出现者的LV舒张功能更差。PDA闭合后LV舒张特性改善；然而，LV舒张特性的改善落后于LV收缩功能的改善。所有患儿在随访>3个月时均无症状且LVEF正常。
经皮闭合PDA与可逆性LV收缩功能障碍有关。LV舒张功能的改善落后于LV收缩功能的改善。
