Heart Failure With Preserved Ejection Fraction in Children

Masutani, Satoshi; Saiki, Hiroshi; Kurishima, Clara; Ishido, Hirotaka; Tamura, Masanori; Senzaki, Hideaki

doi:10.1253/circj.cj-12-1271

Cited by 34 publications

(14 citation statements)

References 29 publications

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“…These responses to treatment can be easily predicted with an understanding of the pressure-volume loop concept, in which the stroke volume and Pes result from the balance between Ees and Ea with a given preload. End-diastolic pressure in this disease in children is only modestly elevated [44]. However, a preload increase by abdominal compression produced markedly elevated end-diastolic pressure (from 10 to 20 mmHg in Fig.…”

Section: Heart Failure With Preserved Ejection Fraction In Childrenmentioning

confidence: 72%

“…Heart failure with preserved EF exists in children [44]. Patients with heart failure and preserved EF (Fig.…”

Section: Heart Failure With Preserved Ejection Fraction In Childrenmentioning

confidence: 99%

“…Patients with heart failure and preserved EF (Fig. 5.18c) have ventricular and arterial stiffening [44,45]. In these children, large amounts of diuretics are required to avoid congestion despite normal renal function, indicating severe heart failure.…”

Section: Heart Failure With Preserved Ejection Fraction In Childrenmentioning

confidence: 99%

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Assessment of Ventricular Function Using the Pressure-Volume Relationship

Masutani

Senzaki

2014

Congenital Heart Disease

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Pressure-volume relationships clearly demonstrate loading conditions (preload and afterload) and cardiac function (systolic and diastolic functions) as well as those relationships in a single plane. These advantages are greatly helpful to understanding the hemodynamics of patients with congenital heart disease, in which loading conditions as well as intrinsic heart functions may become greatly altered on medical, catheter, or surgical interventions. Stroke volume and end-systolic pressure (Pes) result from the balance between contractility and afterload, i.e., between end-systolic elastance (Ees) and effective arterial elastance (Ea) in a given preload. Ventricular-arterial coupling (Ees/Ea or Ea/Ees) is closely related to heart energy. The position and the slope of end-diastolic pressure-volume relation provide information about intrinsic myocardial stiffness, although it is also affected by factors outside the left ventricle (external constraint). While obtaining the actual pressure-volume loops requires invasive measurement, a noninvasive pressure-volume assessment is possible upon consideration of all clinical symptoms and history. This noninvasive approach also helps clinicians select an optimal therapy and assess the consequent changes based upon the evaluation of each factor and those interactions. Hence, the importance of understanding this "classic" concept remains unchanged for pediatric cardiologists managing the complicated hemodynamics of congenital heart disease.

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Section: Heart Failure With Preserved Ejection Fraction In Childrenmentioning

confidence: 72%

“…Heart failure with preserved EF exists in children [44]. Patients with heart failure and preserved EF (Fig.…”

Section: Heart Failure With Preserved Ejection Fraction In Childrenmentioning

confidence: 99%

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Assessment of Ventricular Function Using the Pressure-Volume Relationship

Masutani

Senzaki

2014

Congenital Heart Disease

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“…The LAV was indexed using BSA to the power of the derived AE that was then regressed against BSA to assess for a residual relationship. 16 LVDd% of normal (LVDd%N) 24 was calculated in percent as estimated LVDd, where estimated LVDd (in mm)=0.495× BH (in cm)-5.43. 18 To seek an easier but accurate correction of LAV4CV, we performed linear regression between LAV4CV and BH, and obtained the estimated LAV4CV by BH.…”

Section: Discussionmentioning

confidence: 99%

“…We enrolled 53 consecutive ELBWI patients (25 boys, 28 girls; mean gestational age 26.3±2.6 [23][24][25][26][27][28][29][30][31] weeks), birth weight 738±162 g) who were admitted to the neonatal intensive care unit (NICU) at Kanagawa Children's Medical Center on day 0 between January 2010 and February 2011. The following were the indications for surgical closure of PDA: (1) further ventilatory support; (2) progressive congestive heart failure despite medical management; (3) large left-to-right shunt; (4) LA enlargement indicated by an LA/Ao ratio >1.3; and (5) peak left pulmonary artery end-diastolic velocity (LPA edv) >20 cm/s on echocardiography.…”

Section: Patientsmentioning

confidence: 99%

Left Atrial Volume Is Superior to the Ratio of the Left Atrium to Aorta Diameter for Assessment of the Severity of Patent Ductus Arteriosus in Extremely Low Birth Weight Infants

Toyoshima

Masutani

Senzaki

et al. 2014

Circ J

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Background: This study was undertaken to establish the appropriate correction of left atrial volume (LAV) to body surface area (BSA) to provide reference values and to assess the hypotheses that LAV is useful for assessing patent ductus arteriosus (PDA) severity in extremely low birth weight infants (ELBWI) and could overcome the limitations of the LA-to-aortic dimension ratio (LA/Ao). Methods and Results:Echocardiograms with 318 data points from 53 consecutive ELBWIs were assessed. PDA surgery was performed within the first 2 weeks in 6 patients. LAV was measured using the biplane (LAV) and singleplane (LAV4CV) area-length methods. The allometric model was used to correlate LAV to BSA. LAV4CV had a good correlation with LAV (R=0.93). Although LAV/BSA 1 had a residual relationship with BSA, LAV/BSA 1.54 (23.5±9.3 ml/m 3.08 ) and LAV4CV/BSA 1.52 (21.4±9.4 ml/m 3.04 ) did not. Receiver-operating characteristic analysis to detect hemodynamic status just before PDA surgery showed the superiority of LAV/BSA 1.54 (area under the curve (AUC) 0.97) and LAV4CV/ BSA 1.52 (AUC 0.98) over LA/Ao (AUC 0.92). Moreover, LAV/BSA 1.54 and LAV4CV/BSA 1.52 were better correlated with left pulmonary arterial end-diastolic velocity than was LA/Ao. Conclusions:This study provided appropriate BSA correction of LAV and its reference values in ELBWIs. LAV indices may be superior to LA/Ao for PDA severity assessment. Measurement of single-plane LAV is easy, with similar usefulness to biplane LAV. (Circ J 2014; 78: 1701 -1709

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Pharmacological Heart Failure Therapy in Children: Focus on Inotropic Support

Schranz

2019

Handbook of Experimental Pharmacology

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Heart Failure With Preserved Ejection Fraction in Children

Abstract: HFpEF does exist in children. A common pathophysiology underlies childhood and adult HFpEF despite considerable epidemiological and etiological differences. Future controlled studies are warranted to assess the cause-effect relationship between unique hormonal profiles and HFpEF.

Cited by 34 publications

References 29 publications

Assessment of Ventricular Function Using the Pressure-Volume Relationship

Assessment of Ventricular Function Using the Pressure-Volume Relationship

Left Atrial Volume Is Superior to the Ratio of the Left Atrium to Aorta Diameter for Assessment of the Severity of Patent Ductus Arteriosus in Extremely Low Birth Weight Infants

Pharmacological Heart Failure Therapy in Children: Focus on Inotropic Support

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