Myocardial perfusion and coronary flow reserve assessed by positron emission tomography in patients after Fontan-like operations

M. Hauser, F. M. Bengel, A. Kühn, U. Sauer, S. G. Nekolla, A. Eicken, M. Schwaiger, J. Hess

Research output: Contribution to journalArticle

Abstract

Ventricular dysfunction in patients after Fontan-like operations (FLOs) is a serious complication that might contribute to poor long-term results. Ischemic heart disease will have debilitating consequences on a Fontan heart. Ten patients (15.8 ± 5.01 years) after FLO had transesophageal echocardiography and cardiac catheterization 9.3 ± 4.2 years after surgery. Myocardial perfusion was assessed by NH3-positron emission tomography (rest/adenosine) and compared with that of 10 healthy adults (26.1 ± 6.3 years). Ventricular function was normal in 4 and reduced in 6 patients; end systolic and end diastolic meridional wall stress was significantly elevated in the FLO group. Coronary angiography revealed no stenosis of the coronaries. Compared to normals, myocardial blood flow (MBF) at rest was higher in the FLO group (0.99 ± 0.25 vs 0.77 ± 0.17 ml/g/min, p <0.05), whereas MBF after vasodilatation (2.12 ± 0.78 vs 3.10 ± 0.85 ml/g/min, p <0.05) and coronary flow reserve (CFR) was reduced (2.5 ± 0.88 vs 4.1 ± 1.01, p <0.05), especially in those with impaired ventricular function. Coronary vascular resistance after vasodilatation was elevated in the FLO group (38.2 ± 17.4 vs 24.5 ± 8.3 mmHg/ml/g/min, p <0.05). Altered MBF, increased meridional wall stress, and impaired CFR are common findings in FLO. Attenuated CFR and reduced ventricular function are significantly correlated and may be risk factors for the long-term outcome.

Original languageEnglish (US)
Pages (from-to)386-392
Number of pages7
JournalPediatric Cardiology
Volume24
Issue number4
DOIs
StatePublished - Jul 2003
Externally publishedYes

Fingerprint

Fontan Procedure
Positron-Emission Tomography
Perfusion
Ventricular Function
Vasodilation
Ventricular Dysfunction
Coronary Stenosis
Transesophageal Echocardiography
Cardiac Catheterization
Coronary Angiography
Vascular Resistance
Adenosine
Myocardial Ischemia

Keywords

  • Coronary disease
  • Fontan procedure
  • Microcirculation
  • Positron emission tomography imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Myocardial perfusion and coronary flow reserve assessed by positron emission tomography in patients after Fontan-like operations. / Hauser, M.; Bengel, F. M.; Kühn, A.; Sauer, U.; Nekolla, S. G.; Eicken, A.; Schwaiger, M.; Hess, J.

In: Pediatric Cardiology, Vol. 24, No. 4, 07.2003, p. 386-392.

Research output: Contribution to journalArticle

Hauser, M, Bengel, FM, Kühn, A, Sauer, U, Nekolla, SG, Eicken, A, Schwaiger, M & Hess, J 2003, 'Myocardial perfusion and coronary flow reserve assessed by positron emission tomography in patients after Fontan-like operations', Pediatric Cardiology, vol. 24, no. 4, pp. 386-392. https://doi.org/10.1007/s00246-002-0355-5
Hauser, M. ; Bengel, F. M. ; Kühn, A. ; Sauer, U. ; Nekolla, S. G. ; Eicken, A. ; Schwaiger, M. ; Hess, J. / Myocardial perfusion and coronary flow reserve assessed by positron emission tomography in patients after Fontan-like operations. In: Pediatric Cardiology. 2003 ; Vol. 24, No. 4. pp. 386-392.
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AU - Schwaiger, M.

AU - Hess, J.

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AB - Ventricular dysfunction in patients after Fontan-like operations (FLOs) is a serious complication that might contribute to poor long-term results. Ischemic heart disease will have debilitating consequences on a Fontan heart. Ten patients (15.8 ± 5.01 years) after FLO had transesophageal echocardiography and cardiac catheterization 9.3 ± 4.2 years after surgery. Myocardial perfusion was assessed by NH3-positron emission tomography (rest/adenosine) and compared with that of 10 healthy adults (26.1 ± 6.3 years). Ventricular function was normal in 4 and reduced in 6 patients; end systolic and end diastolic meridional wall stress was significantly elevated in the FLO group. Coronary angiography revealed no stenosis of the coronaries. Compared to normals, myocardial blood flow (MBF) at rest was higher in the FLO group (0.99 ± 0.25 vs 0.77 ± 0.17 ml/g/min, p <0.05), whereas MBF after vasodilatation (2.12 ± 0.78 vs 3.10 ± 0.85 ml/g/min, p <0.05) and coronary flow reserve (CFR) was reduced (2.5 ± 0.88 vs 4.1 ± 1.01, p <0.05), especially in those with impaired ventricular function. Coronary vascular resistance after vasodilatation was elevated in the FLO group (38.2 ± 17.4 vs 24.5 ± 8.3 mmHg/ml/g/min, p <0.05). Altered MBF, increased meridional wall stress, and impaired CFR are common findings in FLO. Attenuated CFR and reduced ventricular function are significantly correlated and may be risk factors for the long-term outcome.

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