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Haemodynamic characterisation and heart catheterisation complications in children with pulmonary hypertension
- 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.
- Subjects :
- Male
Cardiac Catheterization
Time Factors
medicine.medical_treatment
Cardiac index
030204 cardiovascular system & hematology
Global Health
DISEASE
OXYGEN
Congenital
0302 clinical medicine
Outcome Assessment, Health Care
Prospective Studies
Registries
Prospective cohort study
Child
Cardiac catheterization
Central venous pressure
Pulmonary
ASSOCIATION
PERIOPERATIVE COMPLICATIONS
Child, Preschool
Hypertension
Cardiology
SURVIVAL
Heart defects
Female
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Adolescent
Hypertension, Pulmonary
Pulmonary Artery
Risk Assessment
03 medical and health sciences
Catheterisation
Paediatrics
Internal medicine
medicine.artery
medicine
Humans
ANESTHESIA
business.industry
Hemodynamics
Infant
medicine.disease
Pulmonary hypertension
Confidence interval
030228 respiratory system
Pulmonary artery
ARTERIAL-HYPERTENSION
CARDIAC-CATHETERIZATION
Complication
business
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 18741754 and 01675273
- Volume :
- 203
- Database :
- OpenAIRE
- Journal :
- International Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....08f8302ee4e8a5e2e16dd891d2964115