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Haemodynamic characterisation and heart catheterisation complications in children with pulmonary hypertension

Authors :
Rana Olguntürk
Siegrun Mebus
Ralf Geiger
Tilman Humpl
Ornella Milanesi
Maurice Beghetti
M. Fasnacht Boillat
Dursun Alehan
Damien Bonnet
I. Schulze-Neick
Tomás Pulido
V. Favero
R.J. Barst
Serdar Kula
A.M. Atz
Zhi-Cheng Jing
George B. Mallory
László Ablonczy
H. Brun
Johannes M. Douwes
Robert G. Weintraub
M. Zuk
Ch. Apitz
Eric D. Austin
Ronald W. Day
W. Kawalec
T. Jensen
J.T. Berger
L. Moll
Tsutomu Saji
Marilyne Levy
Delphine Yung
S. Mattos
P. De La Garza
Lars Søndergaard
D. Dunbar Ivy
Rolf M. F. Berger
Z.Y. Han
András Szatmári
K. Michalak
D.J. Moore
Jeffrey A. Feinstein
Cardiovascular Centre (CVC)
Vascular Ageing Programme (VAP)
Source :
International Journal of Cardiology, 203, 325-330. ELSEVIER IRELAND LTD
Publication Year :
2016
Publisher :
ELSEVIER IRELAND LTD, 2016.

Abstract

Background The TOPP Registry has been designed to provide epidemiologic, diagnostic, clinical, and outcome data on children with pulmonary hypertension (PH) confirmed by heart catheterisation (HC). This study aims to identify important characteristics of the haemodynamic profile at diagnosis and HC complications of paediatric patients presenting with PH. Methods and results HC data sets underwent a blinded review for confirmation of PH (defined as mean pulmonary arterial pressure≥25mmHg, pulmonary capillary wedge pressure≤12mmHg and pulmonary vascular resistance index [PVRI] of >3WU×m 2 ). Of 568 patients enrolled, 472 who fulfilled the inclusion criteria and had sufficient data from HC were analysed. A total of 908 diagnostic and follow-up HCs were performed and complications occurred in 5.9% of all HCs including five (0.6%) deaths. General anaesthesia (GA) was used in 53%, and conscious sedation in 47%. Complications at diagnosis were more likely to occur if GA was used (p=0.04) and with higher functional class (p=0.02). Mean cardiac index (CI) was within normal limits at diagnosis when analysed for the entire group (3.7L/min/m 2 ; 95% confidence interval 3.4–4.1), as was right atrial pressure despite a severely increased PVRI (16.6WU×m 2, 95% confidence interval 15.6–17.76). However, 24% of the patients had a CI of 2 at diagnosis. A progressive increase in PVRI and decrease in CI was observed with age (p Conclusion In TOPP, haemodynamic assessment was remarkable for preserved CI in the majority of patients despite severely elevated PVRI. HC-related complication incidence was 5.9%, and was associated with GA and higher functional class.

Details

Language :
English
ISSN :
18741754 and 01675273
Volume :
203
Database :
OpenAIRE
Journal :
International Journal of Cardiology
Accession number :
edsair.doi.dedup.....08f8302ee4e8a5e2e16dd891d2964115