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Left ventricular function in adolescents and adults with restrictive ventricular septal defect and moderate left-to-right shunting

Published online by Cambridge University Press:  19 August 2008

Alan G. Magee ,
Lynn Fenn ,
Joric Vellekoop  and
Michael J. Godman
Alan G. Magee*
Affiliation:
Royal Hospital for Sick Children, Edinburgh, UK
Lynn Fenn
Affiliation:
Western General Hospital, Edinburgh, UK
Joric Vellekoop
Affiliation:
Royal Hospital for Sick Children, Edinburgh, UK
Michael J. Godman
Affiliation:
Royal Hospital for Sick Children, Edinburgh, UK
*
Alan G Magee, Consultant Paediatric Cardiologist, Royal Brompton and Harefield NHS Trust, Sydney Street, London 5W3 6NP, UK Tel 0171 352 8121, Fax 0171 351 8547, E-mail [email protected]
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Abstract

Background

The long-term haemodynamic effects of a restrictive ventricular septal defect permitting moderate left-to-right shunting are not known.

Patients and methods

Echocardiographic measure ments of left heart dimensions and function were compared between a group of 9 older children and adults (median age 21 years, range 12–24.5 years) having restrictive ventricular septal defects (median Qp/Qs 1.7, range 1.4–2.1) and a group of 10 age matched controls.

Results

Left ventricular mass indexed to body surface area was significantly greater in subjects than in controls (102±29 vs. 75±13 g/m2, p=0.02), although there was no significant difference in the ratio of mass to volume. There were no significant differ ences between indexes of left ventricular systolic function. Ratios of peak early to late diastolic ventricular filling were lower in those with septal defects (1.5±0.3 vs. 1.8±0.3, p=0.013), but there were no differences in other indexes of diastolic function.

Conclusions

Resting left ventricular function does not appear to have deteriorated by early adult life in patients with restrictive ventricular septal defects and moderate volume loading. This would support a continued conservative approach to management in these patients.

Keywords

Ventricular septal defectleft ventricular functionadult congenital heart disease
Type
Original Articles
Information
Cardiology in the Young , Volume 10 , Issue 2 , March 2000 , pp. 126 - 129
Copyright
Copyright © Cambridge University Press 2000

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