Quantitative evaluation of hemodynamics in the Fontan circulation: a cross-sectional study measuring energy loss in vivo.
Quantitative evaluation of hemodynamics in the Fontan circulation: a cross-sectional study measuring energy loss in vivo.
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Fontan循环中血液动力学的定量评估：一项横断面研究，测量体内能量损失。
DOI：
10.1007/s00246-013-0783-4
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发表时间：
2014-02
影响因子：
1.6
通讯作者：
Ishii, Masahiro
中科院分区：
文献类型：
--
作者：
Honda, Takashi;Itatani, Keiichi;Takanashi, Manabu;Mineo, Eri;Kitagawa, Atsushi;Ando, Hisashi;Kimura, Sumito;Nakahata, Yayoi;Oka, Norihiko;Miyaji, Kagami;Ishii, Masahiro
Fontan吻合处的流动能量损失（EL）被认为反映了流动效率并影响Fontan循环中的血流动力学，并且经常在数值研究中进行讨论。然而，在体内EL测量迄今尚未报告。我们直接测量EL在Fontan循环，并检查结构配置和EL之间的关系，以及EL的影响，在Fontan循环的血流动力学。我们在Fontan手术后1年对9名患者（平均年龄2.3 ± 0.3岁）进行了导管研究，同时测量压力和流速，以计算EL。测得的EL为9.66 ± 8.50 mW。1例左肺动脉狭窄患者的EL最高（17.78 mW），1例双侧上级腔静脉伴左膈神经麻痹患者的EL次之（14.62 mW）。在等容舒张期，EL与时间常数τ显著相关，与max-dp/dt弱相关（r分别为0.795和-0.574）。EL还与等容收缩期的最大dp/dt相关（r = 0.842），但与射血分数或体循环血流量无关（r分别为0.384和-0.034）。总之，无效的结构配置和膈神经麻痹似乎与Fontan吻合口的EL增加有关。虽然这些初步研究结果也表明，EL与心室舒张功能受损，一个长期的研究，大规模的人口是必要的，以达到这样一个明确的结论。
Flow energy loss (EL) at the Fontan anastomosis has been thought to reflect flow efficiencies and to influence on hemodynamics in the Fontan circulation and has been often discussed in numerical studies. However, in vivo EL measurements have to date not been reported. We directly measured EL in the Fontan circulation and examined the relationship between the structural configuration and EL, as well as the influence of EL, on the hemodynamics in the Fontan circulation. We performed a catheterization study measuring simultaneous pressure and flow velocity to calculate EL in nine patients (mean age 2.3 ± 0.3 years) 1 year after the Fontan procedure. The measured EL was 9.66 ± 8.50 mW. One patient with left pulmonary artery stenosis recorded the highest EL (17.78 mW), and one patient with bilateral superior vena cava and left phrenic nerve palsy recorded the second highest EL (14.62 mW). EL significantly correlated with time constant tau and weakly with max-dp/dt during the isovolumic diastolic phase (r = 0.795 and −0.574, respectively). EL also correlated with max-dp/dt during the isovolumic systolic phase (r = 0.842) but not with ejection fraction or systemic blood flow (r = 0.384 and −0.034, respectively). In conclusion, inefficient structural configuration and phrenic nerve palsy seem to be related with increased in EL at the Fontan anastomosis. Although these preliminary findings also suggest that EL is associated with an impaired relaxation of the ventricle, a long-term study with a large population is warranted to reach such a definitive conclusion.
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影响因子：
37.8
作者：
Pekkan, K;Kitajima, HD;Yoganathan, AP
通讯作者：
Yoganathan, AP
DOI：
10.1016/0735-1097(96)00135-0
发表时间：
1996-08-01
影响因子：
24
作者：
Cetta, F;Feldt, RH;Danielson, GK
通讯作者：
Danielson, GK
影响因子：
37.8
作者：
Whitehead, Kevin K.;Pekkan, Kerem;Fogel, Mark A.
通讯作者：
Fogel, Mark A.
影响因子：
3.8
作者：
Marsden, Alison L.;Vignon-Clementel, Irene E.;Taylor, Charles A.
通讯作者：
Taylor, Charles A.
DOI：
10.1016/s0735-1097(00)01164-5
发表时间：
2001-03-01
影响因子：
24
作者：
Mair, DD;Puga, FJ;Danielson, GK
通讯作者：
Danielson, GK