Abnormal myocardial blood flow in children with mild/moderate aortic stenosis. (10th February 2015)

• Record Type: Journal Article
• Authors: Madriago, Erin; Wells, Ronald; Sahn, David J.; Diggs, Brian S.; Langley, Stephen M.; Woodward, Daniel J.; Jerosch-Herold, Michael; Silberbach, Michael
• Is Part Of: Cardiology in the young. Volume 25:Number 7(2015)
• Page Start: 1358
• Page End: 1366
• Publication Date: 2015-02-10
• Subjects: Pediatric cardiology -- Periodicals; 618.9212
• DOI: 10.1017/S1047951114002583
• Languages: English
• ISSNs: 1047-9511

Abstract

<abstract abstract-type="normal"> <title>Abstract</title> <sec id="abs1" sec-type="general"> <title>Objective</title> <p>To quantify myocardial blood flow in infants and children with mild or moderate aortic stenosis using adenosine-infusion cardiac magnetic resonance.</p> </sec> <sec id="abs2" sec-type="general"> <title>Background</title> <p>It is unclear whether asymptomatic children with mild/moderate aortic stenosis have myocardial abnormalities. In addition, cardiac magnetic resonance-determined normative myocardial blood flow data in children have not been reported.</p> </sec> <sec id="abs3" sec-type="methods"> <title>Methods</title> <p>We studied 31 infants and children with either haemodynamically normal hearts (n=20, controls) or mild/moderate aortic stenosis (n=11). The left ventricular myocardium was divided into six segments, and the change in average segmental signal intensity during contrast transit was used to quantify absolute flow (ml/g/minute) at rest and during adenosine infusion by deconvolution of the tissue curves with the arterial input of contrast.</p> </sec> <sec id="abs4" sec-type="results"> <title>Results</title> <p>In all the cases, adenosine was well tolerated without complications. The mean pressure gradient between the left ventricle and the ascending aorta was higher in the aortic stenosis group compared with controls (24 versus 3 mmHg, p<0.001). Left ventricular wall mass was slightly higher in the aortic stenosis group compared with controls (65 versus 50 g/m<sup>2</sup>, p<0.05). After adenosine treatment, both the absolute increase in myocardial blood flow (p<0.0001) and the hyperaemic flow significantly decreased (p<0.001) in children with mild/moderate aortic stenosis compared with controls.</p> </sec> <sec id="abs5" sec-type="conclusion"> <title>Conclusion</title> <p>Abnormal myocardial blood flow in children with mild/moderate aortic stenosis may be an important therapeutic target.</p> </sec> </abstract>