Left ventricular parallel conductance during cardiac cycle in children with congenital heart disease. 1997

P A White, and R R Chaturvedi, and D Shore, and C Lincoln, and R S Szwarc, and A J Bishop, and P J Oldershaw, and A N Redington
Department of Paediatric Cardiology, Royal Brompton Hospital, London, United Kingdom.

This study examines the accuracy of the conductance catheter technique and, in particular, parallel conductance [expressed as offset volume (Vc)] changes during the cardiac cycle in the human left ventricle. Two groups of patients were assessed: group 1, with an open atrial septal defect, and group 2, with an interventricular communication. In a subgroup, pre- and postoperative data were compared to assess the possible impact of shunting or anatomic considerations on our measurements. Vc is normally obtained by a saline-dilution technique previously described by Baan et al. [Vc(Baan); J. Baan, E. T. Van der velde, H. G. Debruin, G. J. Smeenk, J. Koops, A. D. Van Dijk, D. Temmerman, P. J. Senden, and B. Buis. Circulation 70: 812-823, 1984]. This does not take into account potential changes during the cardiac cycle. Four cardiac cycles were taken from the hypertonic saline washin and were divided into six equal isochrones between the maximum and minimum first derivatives of left ventricular pressure (dP/dtmax and dP/dtmin, respectively). The apparent ventricular volume was regressed against stroke volume for the corresponding cardiac cycle. The volume at the gamma-intercept corresponds to the Vc at each time interval [Vc(t)]. In group 1, there was a variation in Vc(t) during systole, but the temporal changes were quite small, on the order of 4.28% (SD = 5.18%) of total corrected end-diastolic volume (mean maximal variation of 2.60 ml). Furthermore, the value of Vc obtained at dP/dtmax was not significantly different from that obtained at dP/dtmin. For group 2 as a whole, mean Vc(Baan) did not change significantly with ventricular septal defect closure (preoperative, 8.85 +/- 11.1 ml; postoperative, 9.82 +/- 11.84 ml). Group 2 children also exhibited a systolic cyclical variation in Vc(t) similar to group 1. Finally, Vc(t) as a percentage of end-diastolic volume was no different when group 1 and group 2 were compared. We conclude that in the left ventricle, even in the presence of a left-to-right shunt, there is a small but insignificant difference in parallel conductance during ventricular ejection. The magnitude of this cyclical change does not preclude ventricular volume measurement in congenital heart disease by the conductance catheter technique.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D012044 Regression Analysis Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable. Regression Diagnostics,Statistical Regression,Analysis, Regression,Analyses, Regression,Diagnostics, Regression,Regression Analyses,Regression, Statistical,Regressions, Statistical,Statistical Regressions
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003971 Diastole Post-systolic relaxation of the HEART, especially the HEART VENTRICLES. Diastoles
D004553 Electric Conductivity The ability of a substrate to allow the passage of ELECTRONS. Electrical Conductivity,Conductivity, Electric,Conductivity, Electrical
D005260 Female Females
D006321 Heart The hollow, muscular organ that maintains the circulation of the blood. Hearts
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse

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