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Interest of β-blockers in patients with right ventricular systemic dysfunction

Published online by Cambridge University Press:  02 June 2010

Rachid Bouallal
Affiliation:
Department of Paediatric Cardiology and Congenital Heart Disease, Cardiology Hospital, University of Lille 2, Lille cedex, France
François Godart*
Affiliation:
Department of Paediatric Cardiology and Congenital Heart Disease, Cardiology Hospital, University of Lille 2, Lille cedex, France
Charles Francart
Affiliation:
Department of Paediatric Cardiology and Congenital Heart Disease, Cardiology Hospital, University of Lille 2, Lille cedex, France
Adélaïde Richard
Affiliation:
Department of Paediatric Cardiology and Congenital Heart Disease, Cardiology Hospital, University of Lille 2, Lille cedex, France
Claude Foucher-Hossein
Affiliation:
Department of Nuclear Medicine, Cardiology Hospital, University of Lille 2, Lille cedex, France
Christophe Lions
Affiliation:
Department of Radiology, Cardiology Hospital, University of Lille 2, Lille cedex, France
*
Correspondence to: F. Godart, MD, PhD, Department of Paediatric Cardiology and Congenital Heart Disease, Service des Maladies Cardiovasculaires Infantiles et Congénitales, Hôpital Cardiologique, CHRU de Lille, University of Lille 2, Bd du Professeur Jules Leclercq, 59037 Lille cedex, France. Tel: +33 32044 5369; Fax: +33 320445456; E-mail: francois.godart@chru-lille.fr

Abstract

Background

β-blockers improve the prognosis of patients with cardiac failure due to left ventricular systolic dysfunction. The aim of this study was to assess the efficacy of β-blockers in patients with dysfunctional systemic right ventricle.

Methods

Fourteen patients with systemic right ventricle following a Mustard or a Senning operation for the transposition of the great arteries, or congenitally corrected transposition were included in the study. All had a decreased systemic right ventricular ejection fraction despite having standard cardiac failure therapy. Quality of life, New York Heart Association class, aerobic capacity, and systemic right ventricular function were assessed before treatment with β-blockers and at the end of the follow-up period, mean of 12.8 months with a range from 3 to 36 months.

Results

Change in New York Heart Association class was significant (p = 0.016). Quality of life improved significantly throughout the study from a median grade 2 with a range from 1 to 3 to a median grade 1 with a range from 1 to 2 (p = 0.008). Systemic right ventricular ejection fraction assessed by radionuclide ventriculography improved significantly from a median of 41% (range: 29–53%) to 49% (range: 29–62%; p = 0.031). However, the change in thee ejection fraction assessed by magnetic resonance imaging was not significant from a median of 29% (range: 12–47%) to 32% (range: 22–63%; p = 0.063).

Conclusion

In patients with cardiac failure due to systemic right ventricular dysfunction, β-blockers improve New York Heart Association class, quality of life, and systemic right ventricular ejection fraction assessed by radionuclide ventriculography.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

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