Scoliosis Surgery Normalizes Cardiac Function in Adolescent Idiopathic Scoliosis Patients

被引:12
作者
Sarwahi, Vishal [1 ]
Galina, Jesse [1 ]
Atlas, Aaron [1 ]
Gecelter, Rachel [1 ]
Hasan, Sayyida [1 ]
Amaral, Terry D. [1 ]
Maguire, Kathleen [2 ]
Lo, Yungtai [3 ]
Kalantre, Sarika [4 ]
机构
[1] Northwell Hlth Syst, Dept Pediat Orthopaed, Cohen Childrens Med Ctr, New Hyde Pk, NY USA
[2] Childrens Hosp Philadelphia, Dept Orthopaed Surg, Philadelphia, PA 19104 USA
[3] Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, Bronx, NY 10467 USA
[4] Univ Hosp New Jersey, Dept Pediat Cardiol, Newark, NJ USA
关键词
adolescent idiopathic scoliosis; pulmonary hypertension; right ventricle systolic pressure; scoliosis; tricuspid regurgitant jet velocity; MITRAL-VALVE PROLAPSE; NATURAL-HISTORY; EXERCISE; PRESSURE; MANAGEMENT; RISK;
D O I
10.1097/BRS.0000000000004060
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. Single-center retrospective chart review with minimum 2-year follow up. Objective. To determine incidence of pulmonary hypertension in adolescent idiopathic scoliosis patients and to determine the effect of scoliosis surgery on pulmonary hypertension. Summary of Background Data. Spinal deformity in adolescent idiopathic scoliosis can increase right atrial and ventricular pressures secondary to restrictive lung disease. Pulmonary hypertension leading to cor pulmonale is the most feared outcome, however mild pulmonary hypertension in adolescent idiopathic scoliosis (AIS) patients has been reported. No study has previously examined changes in the improvement of right heart function following scoliosis surgery. Methods. Cobb angle, 2D-echo signs of structural heart disease, aortic root dimensions, tricuspid regurgitant jet velocity (TRV), pulmonary function tests (PFTs), arterial blood gas (ABG), and patient demographics reviewed. Right ventricular systolic pressure (RVSP) estimated using Bernoulli equation (4[TRV](2)) and right atrial pressure. RVSP >= 36mmHg is a surrogate marker for pulmonary hypertension. All echocardiograms were read by board certified Pediatric Cardiologists. Logistic regression used to assess for differences in TRV between groups. Results. Mean preoperative RVSP was significantly elevated in AIS patients (26.9 +/- 0.49; P< 0.001) compared with controls (17.25+0.88). Only 47 (21%) Group 1 patients had elevated preoperative TRV (>= 2.8 m/s) versus none in Group 2 (P< 0.001). Additionally, logistic regression showed AIS patients have odds ratio of 3.29 for elevated TRV (P= 0.007)-an indirect measure of pulmonary hypertension. In all Group 3 patients, the cardiac function normalized postoperatively (mean TRV = 2.09+0.23; P< 0.001). No association found between Cobb angle, aortic root parameters, or pulmonary function tests. Conclusion. This study found 13.9% of patients with adolescent idiopathic scoliosis had elevated TRV while controls had no TRV abnormalities. Additionally, RVSP measurements demonstrated mild pulmonary hypertension in AIS patients. These abnormal values normalized postoperatively, indicating the benefits of scoliosis surgery on cardiac function in adolescent idiopathic scoliosis.
引用
收藏
页码:E1161 / E1167
页数:7
相关论文
共 25 条
  • [1] NATURAL-HISTORY OF UNTREATED IDIOPATHIC SCOLIOSIS AFTER SKELETAL MATURITY
    ASCANI, E
    BARTOLOZZI, P
    LOGROSCINO, CA
    MARCHETTI, PG
    PONTE, A
    SAVINI, R
    TRAVAGLINI, F
    BINAZZI, R
    DISILVESTRE, M
    [J]. SPINE, 1986, 11 (08) : 784 - 789
  • [2] Prevalence of asymptomatic cardiac valve anomalies in idiopathic scoliosis
    Colomina, MJ
    Puig, L
    Godet, C
    Villanueva, C
    Bago, J
    [J]. PEDIATRIC CARDIOLOGY, 2002, 23 (04) : 426 - 429
  • [3] Physical capacity of girls with mild and moderate idiopathic scoliosis: influence of the size, length and number of curvatures
    Czaprowski, Dariusz
    Kotwicki, Tomasz
    Biernat, Ryszard
    Urniaz, Jerzy
    Ronikier, Aleksander
    [J]. EUROPEAN SPINE JOURNAL, 2012, 21 (06) : 1099 - 1105
  • [4] Incidence and risk factors for mitral valve prolapse in severe adolescent idiopathic scoliosis
    Dhuper, S
    Ehlers, KH
    Fatica, NS
    Myridakis, DJ
    Klein, AA
    Friedman, DM
    Levine, DB
    [J]. PEDIATRIC CARDIOLOGY, 1997, 18 (06) : 425 - 428
  • [5] Effect of idiopathic thoracic scoliosis on the tracheobronchial tree
    Farrell, James
    Garrido, Enrique
    [J]. BMJ OPEN RESPIRATORY RESEARCH, 2018, 5 (01):
  • [6] Ginghina Carmen, 2009, Rom J Intern Med, V47, P109
  • [7] Pulmonary artery catheter and fluid management in acute lung injury and the acute respiratory distress syndrome
    Heresi, Gustavo A.
    Arroliga, Alejandro C.
    Weidemann, Herbert P.
    Matthay, Michael A.
    [J]. CLINICS IN CHEST MEDICINE, 2006, 27 (04) : 627 - +
  • [8] HIRSCHFELD SS, 1982, PEDIATRICS, V70, P451
  • [9] The Findings of Preoperative Cardiac Screening Studies in Adolescent Idiopathic Scoliosis
    Ipp, Lisa
    Flynn, Patrick
    Blanco, John
    Green, Daniel
    Boachie-Adjei, Oheneba
    Kozich, Jeanine
    Chan, Gilbert
    Denneen, John
    Widmann, Roger
    [J]. JOURNAL OF PEDIATRIC ORTHOPAEDICS, 2011, 31 (07) : 764 - 766
  • [10] Pediatric Pulmonary Hypertension
    Ivy, D. Dunbar
    Abman, Steven H.
    Barst, Robyn J.
    Berger, Rolf M. F.
    Bonnet, Damien
    Fleming, Thomas R.
    Haworth, Sheila G.
    Raj, J. Usha
    Rosenzweig, Erika B.
    Neick, Ingram Schulze
    Steinhorn, Robin H.
    Beghetti, Maurice
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2013, 62 (25) : D117 - D126