Right ventricular-pulmonary arterial coupling in patients after repair of tetralogy of Fallot.

Objective: Right ventricular-pulmonary arterial coupling is an important determinant in the development of right ventricular failure. The purpose of our study was to assess right ventricular-pulmonary arterial coupling in children and adolescents with dilatation of the right ventricle after repair of tetralogy of Fallot.

Methods: Right ventricular-pulmonary arterial coupling was quantified as the ratio of pulmonary arterial elastance (an index of arterial load) and right ventricular end-systolic elastance (an index of contractility) using pressure-volume loops with conductance catheters at the baseline level and during dobutamine infusion.

Noninvasive cardiac output measurement at rest and during exercise in pediatric patients after interventional or surgical atrial septal defect closure.

In the majority of patients, secundum atrial septal defects (ASDs) are treated interventionally or surgically, before the onset of clinical symptoms, between 3 and 6 years of age. Because right-ventricular dimensions usually normalize after ASD closure, it has been assumed that cardiac function and exercise performance also normalize at long-term follow-up. The aim of our study was to determine cardiac index (CI) at rest and during exercise at medium-term follow-up of children who had undergone surgical or interventional closure of ASD because no such reports have been published thus far.

Impact of restrictive physiology on intrinsic diastolic right ventricular function and lusitropy in children and adolescents after repair of tetralogy of Fallot.

Background: Restrictive right ventricular (RV) physiology is a phenomenon considered potentially beneficial when detected in children and adolescents with repaired tetralogy of Fallot (ToF). It is typically characterised by antegrade flow in the pulmonary artery in late diastole at the time of atrial contraction. However, little is known about the impact of restrictive physiology on intrinsic diastolic RV function or lusitropy.