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Systemic right ventricle: possible cause of ventricular dysfunction?
Systemic Right Ventricle: Possible Cause of Ventricular Dysfunction? Thomas P. Graham, Jr., he investigators from the Adult Congenital Heart Program at the Royal Brompton Hospital in LonT don have presented a brief report regarding the relation between right ventricular hypertrophy and systemic ventricular function in adults who have had atrial repair of transposition of the great arteries.1 Although the numbers are relatively small and there is some overlap in the data as presented, the hypothesis does seem reasonable. When these data are coupled with the information regarding myocardial perfusion abnormalities in patients after atrial repair of transposition (see references 7 and 8 in Hornung et al’s From the Department of Pediatric Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee. Manuscript received and accepted April 17, 2002. Address for reprints: Thomas P. Graham, Jr., MD, Department of Pediatric Cardiology, Vanderbilt University Medical Center, 1161 21st Ave., So (D2220 MCN), Nashville, Tennessee. E-mail: tom. [email protected].
©2002 by Excerpta Medica, Inc. All rights reserved. The American Journal of Cardiology Vol. 90 October 1, 2002
MD
study1), the possibility of excessive hypertrophy being associated with inadequate coronary flow reserve is an intriguing explanation for the ventricular dysfunction that occurs in many adult patients with a systemic right ventricle. The short-term implications would suggest that therapy to limit afterload, thus minimizing myocardial oxygen demands becomes more important. In terms of the long-term implications, the advances in specific-targeted molecular therapy to enhance vascular beds, and in particular coronary flow reserve, raises exciting possibilities for this group of patients as well as others with systemic right ventricles.
1. Hornung TS, Kilner PJ, Davlouros PA, Grothues F, Li W, Gatzoulis MA.
Excessive right ventricular hypertrophic response in adults with the Mustard procedure for transposition of the great arteries. Am J Cardiol 2002;90:800 – 803.
0002-9149/02/$–see front matter PII S0002-9149(02)02604-8
755
©2002 by Excerpta Medica, Inc. All rights reserved. The American Journal of Cardiology Vol. 90 October 1, 2002
MD
study1), the possibility of excessive hypertrophy being associated with inadequate coronary flow reserve is an intriguing explanation for the ventricular dysfunction that occurs in many adult patients with a systemic right ventricle. The short-term implications would suggest that therapy to limit afterload, thus minimizing myocardial oxygen demands becomes more important. In terms of the long-term implications, the advances in specific-targeted molecular therapy to enhance vascular beds, and in particular coronary flow reserve, raises exciting possibilities for this group of patients as well as others with systemic right ventricles.
1. Hornung TS, Kilner PJ, Davlouros PA, Grothues F, Li W, Gatzoulis MA.
Excessive right ventricular hypertrophic response in adults with the Mustard procedure for transposition of the great arteries. Am J Cardiol 2002;90:800 – 803.
0002-9149/02/$–see front matter PII S0002-9149(02)02604-8
755