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November 7, 2000Circulation

Failure of Stroke Volume Augmentation During Exercise and Dobutamine Stress Is Unrelated to Load-Independent Indexes of Right Ventricular Performance After the Mustard Operation

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Why the study?

Does dobutamine or exercise stress augment stroke volume and right ventricular performance in asymptomatic survivors of the Mustard operation?

Population

14 asymptomatic survivors of the Mustard operation for transposition of the great arteries

Comparison

Dobutamine infusion and upright exercise testing… vs Baseline resting state

Design

Cohort

Authors

GDGraham P. DerrickGreat Ormond Street HospitalINIndra NarangUniversity of TorontoPWPaul A. WhiteHealth Canada

Discussion

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Implication

Impaired RV filling, not contractility, limits stroke volume in Mustard survivors; hypothesis-generating for pathway-targeted interventions.

Structured PICO

Does dobutamine or exercise stress augment stroke volume and right ventricular performance in asymptomatic survivors of the Mustard operation?

P
Population
14 asymptomatic survivors of the Mustard operation for transposition of the great arteries
I
Intervention
Dobutamine infusion (0, 5, and 10 μg/kg/min) and upright exercise testing on a bicycle ergometer
C
Comparator
Baseline resting state
O
Outcome
Stroke volume index response and load-independent indexes of right ventricular performance (end-systolic pressure volume relation, preload recruitable stroke work index, VA coupling, isovolumic relaxation, end-diastolic pressure-volume relations, dV/dt)surrogate

In Mustard operation survivors, the failure to augment stroke volume during stress is driven by impaired right ventricular filling due to abnormal intra-atrial pathways, rather than intrinsic myocardial contractile dysfunction.

Cite This Study

Derrick et al. (2000) studied this question.

synapsesocial.com/papers/6a91afed31e2b75bf0e3c8b1https://doi.org/10.1161/circ.102.suppl_3.iii-154
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Haemodynamics in children during rest and exercise: methods and normal values1998 · 26 citations
  2. 2Continuous measurement of left ventricular volume in animals and humans by conductance catheter.1984 · 905 citations
  3. 3Cardiopulmonary adaptation at rest and during exercise 10 years after Mustard atrial repair for transposition of the great arteries.1988 · 44 citations
  4. 4Right and left ventricular function at rest and with exercise after the Mustard operation for transposition of the great arteries.1984 · 52 citations