dc.contributor.author
Fernandes, Joao Filipe
dc.contributor.author
Goubergrits, Leonid
dc.contributor.author
Bruening, Jan
dc.contributor.author
Hellmeier, Florian
dc.contributor.author
Nordmeyer, Sarah
dc.contributor.author
da Silva, Tiago Ferreira
dc.contributor.author
Schubert, Stephan
dc.contributor.author
Berger, Felix
dc.contributor.author
Kuehne, Titus
dc.contributor.author
Kelm, Marcus
dc.date.accessioned
2018-06-08T10:45:02Z
dc.date.available
2017-03-15T10:42:34.982Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/21004
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-24301
dc.description.abstract
Background In aortic coarctation, current guidelines recommend reducing
pressure gradients that exceed given thresholds. From a physiological
standpoint this should ideally improve the energy expenditure of the heart and
thus prevent long term organ damage. Objectives The aim was to assess the
effects of interventional treatment on external and internal heart power (EHP,
IHP) in patients with aortic coarctation and to explore the correlation of
these parameters to pressure gradients obtained from heart catheterization.
Methods In a collective of 52 patients with aortic coarctation 25 patients
received stenting and/or balloon angioplasty, and 20 patients underwent MRI
before and after an interventional treatment procedure. EHP and IHP were
computed based on catheterization and MRI measurements. Along with the power
efficiency these were combined in a cardiac energy profile. Results By
intervention, the catheter gradient was significantly reduced from 21.8±9.4 to
6.2±6.1mmHg (p<0.001). IHP was significantly reduced after intervention, from
8.03±5.2 to 4.37±2.13W (p < 0.001). EHP was 1.1±0.3 W before and 1.0±0.3W
after intervention, p = 0.044. In patients initially presenting with IHP above
5W intervention resulted in a significant reduction in IHP from 10.99±4.74 W
to 4.94±2.45W (p<0.001), and a subsequent increase in power efficiency from 14
to 26% (p = 0.005). No significant changes in IHP, EHP or power efficiency
were observed in patients initially presenting with IHP < 5W. Conclusion It
was demonstrated that interventional treatment of coarctation resulted in a
decrease in IHP. Pressure gradients, as the most widespread clinical
parameters in coarctation, did not show any correlation to changes in EHP or
IHP. This raises the question of whether they should be the main focus in
coarctation interventions. Only patients with high IHP of above 5W showed
improvement in IHP and power efficiency after the treatment procedure. Trial
Registration clinicaltrials.gov NCT02591940
de
dc.rights.uri
http://creativecommons.org/licenses/by/4.0/
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit
dc.title
Beyond Pressure Gradients
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation
PLoS ONE. - 12 (2017), 1, Artike Nr. e0168487
dc.title.subtitle
The Effects of Intervention on Heart Power in Aortic Coarctation
dcterms.bibliographicCitation.doi
10.1371/journal.pone.0168487
dcterms.bibliographicCitation.url
http://dx.doi.org/10.1371/journal.pone.0168487
refubium.affiliation
Charité - Universitätsmedizin Berlin
de
refubium.mycore.fudocsId
FUDOCS_document_000000026638
refubium.note.author
Der Artikel wurde in einer reinen Open-Access-Zeitschrift publiziert.
refubium.resourceType.isindependentpub
no
refubium.mycore.derivateId
FUDOCS_derivate_000000007903
dcterms.accessRights.openaire
open access