Evaluation of left ventricular global function, using Doppler Myocardial Performance Index (Tei- index) in patients with systemic Hypertension

Sarkar, Haripada; Siddique, MA; Ahmed, Chaudhury Meshkat; Ahmed, Md. Manjur; Mahmood, Muhammad Arif; Ahsan, S A; Salman, Malik; Habib, Sma; Haque, Kmhs Sirajul

doi:10.3329/uhj.v4i1.1389

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“…This measure has been used extensively in many forms of heart disease, congenital and acquired, and is a useful measure to describe overall ventricular performance [3, 5, 15, 18, 21, 25]. In the single-ventricle population, there are many reports describing the status of the MPI after the Fontan operation, but there are few clinical trials of medical therapies in survivors of Fontan surgery and no studies to date evaluating the potential impact of sildenafil on ventricular performance.…”

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confidence: 99%

Impact of Sildenafil on Echocardiographic Indices of Myocardial Performance After the Fontan Operation

et al. 2012

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The objective of this study was describe the impact of sildenafil on echocardiographic measures of myocardial performance in children and young adults with a functional single-ventricle physiology late after Fontan surgery. A double-blind, placebo-controlled, crossover trial was conducted in children and young adults after the Fontan operation at a single pediatric center. Subjects were randomized to receive placebo or sildenafil (20 mg tid) for 6 weeks. After a 6-week washout period, subjects were crossed for an additional 6 weeks. Each subject underwent an echocardiogram at the start and finish of each phase. A total of 27 subjects completed study testing at a mean age of 14.9 years and a mean time from Fontan surgery of 11.3 years. After sildenafil, subjects demonstrated improvement in their myocardial performance index (MPI; −0.051; 95% CI −0.095, −0.0077; p 0.02) and in the product of the velocity time integral (VTI) of the dominant outflow tract and the heart rate (HR; 110 cm × bpm; 95% CI 7.5, 220; p = 0.04). Measures of diastolic performance, including inflow velocities, myocardial velocities, and the ratio of blood pool velocity to myocardial velocity during passive inflow, did not change. In this cohort, there were significant improvements in both the MPI and the product of the VTI × HR after 6 weeks of treatment with sildenafil. These findings suggest that sildenafil may be a useful therapy to improve or maintain ventricular performance in select patients after the Fontan operation.

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