Skip to main content
Erschienen in: Heart and Vessels 7/2022

10.01.2022 | Original Article

Pulmonary vascular resistance and compliance in pulmonary blood flow alterations in children with congenital heart disease

verfasst von: Yuka Iwaya, Jun Muneuchi, Yuichiro Sugitani, Mamie Watanabe

Erschienen in: Heart and Vessels | Ausgabe 7/2022

Einloggen, um Zugang zu erhalten

Abstract

There is a unique hyperbolic relationship between pulmonary vascular resistance (Rp) and compliance (Cp); however, the characteristics of this coupling curve in pulmonary blood flow alterations remains unknown in children with congenital heart disease. We aimed to explore the Rp–Cp coupling and resistant-compliance (RC) time among them. We retrospectively reviewed catheterization data and calculated Rp and Cp in 217 subjects with ventricular septal defect. Median age and weight at catheterization were 2.8 (1.7–4.4) months and 4.3 (3.7–5.3) kg, respectively. Pulmonary hemodynamic parameters were as follows: mean pulmonary arterial pressure: 36 (28–43) mmHg; the amount of pulmonary blood flow (Qp): 14.2 (11.6–17.6) L/min/m2; Rp: 1.95 (1.38–2.59) Wood unit m2; Cp: 2.98 (2.42–3.88) mmHg/mL/m2; and RC time: 0.35 (0.30–0.40) s. RC time remained unchanged according to alterations in Qp (P = 0.206); however, the relationship between logarithm transformations of Rp and Cp showed more steeper according to an increase in Qp. The pulmonary circulation depends upon Cp rather than Rp according to the degree of Qp despite the constancy in RC time. We should take both Rp and Cp into consideration when evaluating the pulmonary circulation among children with congenital heart disease.
Literatur
1.
Zurück zum Zitat Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M, ESC Scientific Document Group (2016) 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: the Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 37:67–119CrossRef Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M, ESC Scientific Document Group (2016) 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: the Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 37:67–119CrossRef
2.
Zurück zum Zitat Assad TR, Brittain EL, Wells QS, Farber-Eger EH, Halliday SJ, Doss LN, Xu M, Wang L, Harrell FE, Yu C, Robbins IM, Newman JH, Hemnes AR (2016) Hemodynamic evidence of vascular remodeling in combined post- and precapillary pulmonary hypertension. Pulm Circ 6:313–321CrossRef Assad TR, Brittain EL, Wells QS, Farber-Eger EH, Halliday SJ, Doss LN, Xu M, Wang L, Harrell FE, Yu C, Robbins IM, Newman JH, Hemnes AR (2016) Hemodynamic evidence of vascular remodeling in combined post- and precapillary pulmonary hypertension. Pulm Circ 6:313–321CrossRef
3.
Zurück zum Zitat Saouti N, Westerhof N, Postmus PE, Vonk-Noordegraaf A (2010) The arterial load in pulmonary hypertension. Eur Respir Rev 19:197–203CrossRef Saouti N, Westerhof N, Postmus PE, Vonk-Noordegraaf A (2010) The arterial load in pulmonary hypertension. Eur Respir Rev 19:197–203CrossRef
4.
Zurück zum Zitat Tedford RJ (2014) Determinants of right ventricular afterload (2013 Grover Conference series). Pulm Circ 4:211–219CrossRef Tedford RJ (2014) Determinants of right ventricular afterload (2013 Grover Conference series). Pulm Circ 4:211–219CrossRef
5.
Zurück zum Zitat Bonderman D, Martischnig AM, Vonbank K, Nikfardjam M, Meyer B, Heinz G, Klepetko W, Naeije R, Lang IM (2011) Right ventricular load at exercise is a cause of persistent exercise limitation in patients with normal resting pulmonary vascular resistance after pulmonary endarterectomy. Chest 139:122–127CrossRef Bonderman D, Martischnig AM, Vonbank K, Nikfardjam M, Meyer B, Heinz G, Klepetko W, Naeije R, Lang IM (2011) Right ventricular load at exercise is a cause of persistent exercise limitation in patients with normal resting pulmonary vascular resistance after pulmonary endarterectomy. Chest 139:122–127CrossRef
6.
Zurück zum Zitat de Perrot M, McRae K, Shargall Y, Thenganatt J, Moric J, Mak S, Granton JT (2011) Early postoperative pulmonary vascular compliance predicts outcome after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Chest 140:34–41CrossRef de Perrot M, McRae K, Shargall Y, Thenganatt J, Moric J, Mak S, Granton JT (2011) Early postoperative pulmonary vascular compliance predicts outcome after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Chest 140:34–41CrossRef
7.
Zurück zum Zitat Lankhaar JW, Westerhof N, Faes TJ, Gan CT, Marques KM, Boonstra A, van den Berg FG, Postmus PE, Vonk-Noordegraaf A (2008) Pulmonary Vascular resistance and compliance stay inversely related during treatment of pulmonary hypertension. Eur Heart J 29:1688–1695CrossRef Lankhaar JW, Westerhof N, Faes TJ, Gan CT, Marques KM, Boonstra A, van den Berg FG, Postmus PE, Vonk-Noordegraaf A (2008) Pulmonary Vascular resistance and compliance stay inversely related during treatment of pulmonary hypertension. Eur Heart J 29:1688–1695CrossRef
8.
Zurück zum Zitat Mahapatra S, Nishimura RA, Sorajja P, Cha S, McGoon MD (2006) Relationship of pulmonary arterial capacitance and mortality in idiopathic pulmonary arterial hypertension. J Am Coll Cardiol 47:799–803CrossRef Mahapatra S, Nishimura RA, Sorajja P, Cha S, McGoon MD (2006) Relationship of pulmonary arterial capacitance and mortality in idiopathic pulmonary arterial hypertension. J Am Coll Cardiol 47:799–803CrossRef
9.
Zurück zum Zitat Takatsuki S, Nakayama T, Ikehara S, Matsuura H, Ivy DD, Saji T (2017) Pulmonary arterial capacitance index is a strong predictor for adverse outcome in children with idiopathic and heritable pulmonary arterial hypertension. J Pediatr 180:75-79.e2CrossRef Takatsuki S, Nakayama T, Ikehara S, Matsuura H, Ivy DD, Saji T (2017) Pulmonary arterial capacitance index is a strong predictor for adverse outcome in children with idiopathic and heritable pulmonary arterial hypertension. J Pediatr 180:75-79.e2CrossRef
10.
Zurück zum Zitat Dupont M, Mullens W, Skouri HN, Abrahams Z, Wu Y, Taylor DO, Starling RC, Tang WH (2012) Prognostic role of pulmonary arterial capacitance in advanced heart failure. Circ Heart Fail 5:778–785CrossRef Dupont M, Mullens W, Skouri HN, Abrahams Z, Wu Y, Taylor DO, Starling RC, Tang WH (2012) Prognostic role of pulmonary arterial capacitance in advanced heart failure. Circ Heart Fail 5:778–785CrossRef
11.
Zurück zum Zitat Reuben SR (1971) Compliance of the human pulmonary arterial system in disease. Circ Res 29:40–50CrossRef Reuben SR (1971) Compliance of the human pulmonary arterial system in disease. Circ Res 29:40–50CrossRef
12.
Zurück zum Zitat Segers P, Verdonck P, Deryck Y, Brimioulle S, Naeije R, Carlier S, Stergiopulos N (1999) Pulse pressure method and the area method for the estimation of total arterial compliance in dogs: Sensitivity to wave reflection intensity. Ann Biomed Eng 27:480–485CrossRef Segers P, Verdonck P, Deryck Y, Brimioulle S, Naeije R, Carlier S, Stergiopulos N (1999) Pulse pressure method and the area method for the estimation of total arterial compliance in dogs: Sensitivity to wave reflection intensity. Ann Biomed Eng 27:480–485CrossRef
13.
Zurück zum Zitat Chemla D, Lau EM, Papelier Y, Attal P, Hervé P (2015) Pulmonary vascular resistance and compliance relationship in pulmonary hypertension. Eur Respir J 46:1178–1189CrossRef Chemla D, Lau EM, Papelier Y, Attal P, Hervé P (2015) Pulmonary vascular resistance and compliance relationship in pulmonary hypertension. Eur Respir J 46:1178–1189CrossRef
14.
Zurück zum Zitat MacKenzie Ross RV, Toshner MR, Soon E, Naeije R, Pepke-Zaba J (2013) Decreased time constant of the pulmonary circulation in chronic thromboembolic pulmonary hypertension. Am J Physiol Heart Circ Physiol 305:H259–H264CrossRef MacKenzie Ross RV, Toshner MR, Soon E, Naeije R, Pepke-Zaba J (2013) Decreased time constant of the pulmonary circulation in chronic thromboembolic pulmonary hypertension. Am J Physiol Heart Circ Physiol 305:H259–H264CrossRef
15.
Zurück zum Zitat Tedford RJ, Hassoun PM, Mathai SC, Girgis RE, Russell SD, Thiemann DR, Cingolani OH, Borlaug BA, Redfield MM, Lederer DJ, Kass DA (2012) Pulmonary capillary wedge pressure augments right ventricular pulsatile loading. Circulation 125:289–297CrossRef Tedford RJ, Hassoun PM, Mathai SC, Girgis RE, Russell SD, Thiemann DR, Cingolani OH, Borlaug BA, Redfield MM, Lederer DJ, Kass DA (2012) Pulmonary capillary wedge pressure augments right ventricular pulsatile loading. Circulation 125:289–297CrossRef
16.
Zurück zum Zitat Muneuchi J, Nagatomo Y, Watanabe M, Joo K, Onzuka T, Ochiai Y, Joo K (2016) Relationship between pulmonary arterial resistance and compliance among patients with pulmonary arterial hypertension and congenital heart disease. J Thorac Cardiovasc Surg 152:507–513CrossRef Muneuchi J, Nagatomo Y, Watanabe M, Joo K, Onzuka T, Ochiai Y, Joo K (2016) Relationship between pulmonary arterial resistance and compliance among patients with pulmonary arterial hypertension and congenital heart disease. J Thorac Cardiovasc Surg 152:507–513CrossRef
17.
Zurück zum Zitat Ghio S, Schirinzi S, Pica S (2015) Pulmonary arterial compliance: How and why should we measure it? Glob Cardiol Sci Pract 2015:58CrossRef Ghio S, Schirinzi S, Pica S (2015) Pulmonary arterial compliance: How and why should we measure it? Glob Cardiol Sci Pract 2015:58CrossRef
18.
Zurück zum Zitat Gan CT, Lankhaar JW, Westerhof N, Marcus JT, Becker A, Twisk JW, Boonstra A, Postmus PE, Vonk-Noordegraaf A (2007) Noninvasively assessed pulmonary artery stiffness predicts mortality in pulmonary arterial hypertension. Chest 132:1906–1912CrossRef Gan CT, Lankhaar JW, Westerhof N, Marcus JT, Becker A, Twisk JW, Boonstra A, Postmus PE, Vonk-Noordegraaf A (2007) Noninvasively assessed pulmonary artery stiffness predicts mortality in pulmonary arterial hypertension. Chest 132:1906–1912CrossRef
19.
Zurück zum Zitat Sanz J, Kariisa M, Dellegrottaglie S, Prat-González S, Garcia MJ, Fuster V, Rajagopalan S (2009) Evaluation of pulmonary artery stiffness in pulmonary hypertension with cardiac magnetic resonance. JACC Cardiovasc Imaging 2:286–295CrossRef Sanz J, Kariisa M, Dellegrottaglie S, Prat-González S, Garcia MJ, Fuster V, Rajagopalan S (2009) Evaluation of pulmonary artery stiffness in pulmonary hypertension with cardiac magnetic resonance. JACC Cardiovasc Imaging 2:286–295CrossRef
20.
Zurück zum Zitat Saouti N, Westerhof N, Helderman F, Marcus JT, Stergiopulos N, Westerhof BE, Boonstra A, Postmus PE, Vonk-Noordegraaf A (2009) RC time constant of single lung equals that of both lungs together: a study in chronic thromboembolic pulmonary hypertension. Am J Physiol Heart Circ Physiol 297:H2154–H2160CrossRef Saouti N, Westerhof N, Helderman F, Marcus JT, Stergiopulos N, Westerhof BE, Boonstra A, Postmus PE, Vonk-Noordegraaf A (2009) RC time constant of single lung equals that of both lungs together: a study in chronic thromboembolic pulmonary hypertension. Am J Physiol Heart Circ Physiol 297:H2154–H2160CrossRef
21.
Zurück zum Zitat Presson RG Jr, Baumgartner WA Jr, Peterson AJ, Glenny RW, Wagner WW Jr (2002) Pulmonary capillaries are recruited during pulsatile flow. J Appl Physiol (1985) 92:1183–1190CrossRef Presson RG Jr, Baumgartner WA Jr, Peterson AJ, Glenny RW, Wagner WW Jr (2002) Pulmonary capillaries are recruited during pulsatile flow. J Appl Physiol (1985) 92:1183–1190CrossRef
22.
Zurück zum Zitat Lankhaar JW, Westerhof N, Faes TJ, Marques KM, Marcus JT, Postmus PE, Vonk-Noordegraaf A (2006) Quantification of right ventricular afterload in patients with and without pulmonary hypertension. Am J Physiol Heart Circ Physiol 291:H1731–H1737CrossRef Lankhaar JW, Westerhof N, Faes TJ, Marques KM, Marcus JT, Postmus PE, Vonk-Noordegraaf A (2006) Quantification of right ventricular afterload in patients with and without pulmonary hypertension. Am J Physiol Heart Circ Physiol 291:H1731–H1737CrossRef
23.
Zurück zum Zitat Hadinnapola C, Pepke-Zaba J (2015) Developments in pulmonary arterial hypertension-targeted therapy for chronic thromboembolic pulmonary hypertension. Expert Rev Respir Med 9:559–569CrossRef Hadinnapola C, Pepke-Zaba J (2015) Developments in pulmonary arterial hypertension-targeted therapy for chronic thromboembolic pulmonary hypertension. Expert Rev Respir Med 9:559–569CrossRef
Metadaten
Titel
Pulmonary vascular resistance and compliance in pulmonary blood flow alterations in children with congenital heart disease
verfasst von
Yuka Iwaya
Jun Muneuchi
Yuichiro Sugitani
Mamie Watanabe
Publikationsdatum
10.01.2022
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 7/2022
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-021-02009-4

Weitere Artikel der Ausgabe 7/2022

Heart and Vessels 7/2022 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.