Author + information
- Received November 20, 2000
- Revision received February 20, 2001
- Accepted March 1, 2001
- Published online June 15, 2001.
- Tajinder P Singh, MD, FACC∗,* (, )
- Richard A Humes, MD, FACC∗,
- Otto Muzik, PhD‡,§,
- Sambasiva Kottamasu, MD‡,
- Peter P Karpawich, MD, FACC∗ and
- Marcelo F Di Carli, MD, FACC†,‡,§
- ↵*Reprint requests and correspondence:
Dr. T. P. Singh, Division of Cardiology, Children’s Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, Michigan 48111
The purpose of this study was to assess myocardial blood flow (MBF) and flow reserve in systemic right ventricles (RV) in long-term survivors of the Mustard operation.
There is a high prevalence of systemic RV dysfunction and impaired exercise performance in long-term survivors of the Mustard operation. A mismatch between myocardial blood supply and systemic ventricular work demand has been proposed as a potential mechanism.
We assessed MBF at rest and during intravenous adenosine hyperemia in 11 long-term survivors of a Mustard repair (age 18 ± 5 years, median age at repair 0.7 years, follow-up after repair 17 ± 5 years) and 13 healthy control subjects (age 23 ± 7 years), using N-13 ammonia and positron emission tomography imaging.
There was no difference in basal MBF between the systemic RV of survivors of the Mustard operation and the systemic left ventricle (LV) of healthy control subjects (0.80 ± 0.19 vs. 0.74 ± 0.15 ml/g/min, respectively, p = NS). However, the hyperemic flows were significantly lower in systemic RVs than they were in systemic LVs (2.34 ± 0.0.69 vs. 3.44 ± 0.62 ml/g/min respectively, p < 0.01). As a result, myocardial flow reserve was lower in systemic RVs than it was in systemic LVs (2.93 ± 0.63 vs. 4.74 ± 1.09, respectively, p < 0.01).
Myocardial flow reserve is impaired in systemic RVs in survivors of the Mustard operation. This may contribute to systemic ventricular dysfunction in these patients.
☆ Supported by the Children’s Hospital of Michigan (Detroit, Michigan) Research Endowment Fund.
- Received November 20, 2000.
- Revision received February 20, 2001.
- Accepted March 1, 2001.
- American College of Cardiology