{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T23:02:44Z","timestamp":1762642964927,"version":"3.41.2"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:p>Volume loading of the right ventricle (RV) in patients with atrial septal defect (ASD) and patients with repaired Tetralogy of Fallot (rToF) affects the pumping mechanics of the left ventricle (LV). Intervention of the lesion will relieve the RV volume load however quantifiable impact on exercise capacity, arrhytmias or death are limited. A possible explanation could be remaining effects on the function of the LV. The aim of this study was therefore to investigate if hemodynamics of the LV differs between patients with RV volume load due to ASD or rToF and healthy controls and if they change after intervention. Eighteen patients with ASD, 17 patients with rToF and 16 healthy controls underwent cardiac magnetic resonance imaging (CMR) and maximal exercise test with continuous gas analysis. Reexamination was performed 13 \u00b1 2\u00a0months after closure of the ASD in 13 of the patients and 10 \u00b1 4\u00a0months after pulmonary valve replacement (PVR) in 9 of the patients with rToF. Non-invasive PV-loops from CMR and brachial pressures were analyzed. Stroke work (SW) and potential energy (PE) increased after ASD closure but not in ToF patients after valve repair. Patients with ASD or rToF had higher contractility and arterial elastance than controls. No major effects were seen in LV energetics or in peak VO<jats:sub>2<\/jats:sub> after ASD closure or PVR. Peak VO<jats:sub>2<\/jats:sub> correlated positively with SW and PE in patients with ASD (r = 0.54, <jats:italic>p<\/jats:italic> &amp;lt; 0.05; r = 0.61, <jats:italic>p<\/jats:italic> &amp;lt; 0.01) and controls (r = 0.72, <jats:italic>p<\/jats:italic> &amp;lt; 0.01; r = 0.53, <jats:italic>p<\/jats:italic> &amp;lt; 0.05) to approximately the same degree as peak VO<jats:sub>2<\/jats:sub> and end-diastolic volume (EDV) or end-systolic volume (ESV). In ToF patients there was no correlation between PV loop parameters and peak VO<jats:sub>2<\/jats:sub> even if correlation was found between peak VO<jats:sub>2<\/jats:sub> and EDV or ESV. In conclusion, the LV seems to adapt its pumping according to anatomic circumstances without losing efficiency, however there are indications of persistent vascular dysfunction, expressed as high arterial elastance, which might have impact on exercise performance and prognosis. Future studies might elucidate if the duration of RV volume load and decreased LV filling have any impact on the ability of the vascular function to normalize after ASD closure or PVR.<\/jats:p>","DOI":"10.3389\/fphys.2023.1291119","type":"journal-article","created":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T08:09:04Z","timestamp":1701850144000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Patients with volume-loaded right ventricle - quantification of left ventricular hemodynamic response to intervention measured by noninvasive pressure-volume loops"],"prefix":"10.3389","volume":"14","author":[{"given":"Pia","family":"Sj\u00f6berg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigurdur","family":"Stephensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e5kan","family":"Arheden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Einar","family":"Heiberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus","family":"Carlsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"qyad035","DOI":"10.1093\/ehjimp\/qyad035","article-title":"Non-invasive left ventricular pressure-volume loops from cardiovascular magnetic resonance imaging and brachial blood pressure: validation using pressure catheter measurements","volume":"1","author":"Arvidsson","year":"2023","journal-title":"Eur. Heart J. - Imaging Methods Pract."},{"key":"B2","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1161\/CIRCULATIONAHA.113.001485","article-title":"Clinical outcomes of surgical pulmonary valve replacement after repair of tetralogy of Fallot and potential prognostic value of preoperative cardiopulmonary exercise testing","volume":"129","author":"Babu-Narayan","year":"2014","journal-title":"Circulation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"W70","DOI":"10.1097\/rti.0000000000000665","article-title":"Biventricular pressure-volume loop assessment before and after pulmonary valve replacement in tetralogy of fallot","volume":"37","author":"Binka","year":"2022","journal-title":"J. Thorac. Imaging"},{"key":"B4","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1136\/heartjnl-2017-312048","article-title":"A propensity score-adjusted analysis of clinical outcomes after pulmonary valve replacement in tetralogy of Fallot","volume":"104","author":"Bokma","year":"2018","journal-title":"Heart"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1016\/j.amjcard.2010.12.026","article-title":"Prevalence of left ventricular systolic dysfunction in adults with repaired tetralogy of fallot","volume":"107","author":"Broberg","year":"2011","journal-title":"Am. J. Cardiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1007\/s00592-010-0229-x","article-title":"Relationships between maximal oxygen uptake and endothelial function in healthy male adults: a preliminary study","volume":"50","author":"Buscemi","year":"2013","journal-title":"Acta Diabetol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1342","DOI":"10.1152\/japplphysiol.90600.2008","article-title":"Arterial-ventricular coupling: mechanistic insights into cardiovascular performance at rest and during exercise","volume":"105","author":"Chantler","year":"2008","journal-title":"J. Appl. Physiol. (1985)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.artres.2012.12.002","article-title":"Ventricular-arterial coupling: invasive and non-invasive assessment","volume":"7","author":"Chirinos","year":"2013","journal-title":"Artery Res."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.1016\/s0140-6736(13)62145-5","article-title":"Atrial septal defects","volume":"383","author":"Geva","year":"2014","journal-title":"Lancet"},{"key":"B10","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1007\/s00246-018-1819-6","article-title":"Inefficient ventriculoarterial coupling in fontan patients: a cardiac magnetic resonance study","volume":"39","author":"Godfrey","year":"2018","journal-title":"Pediatr. Cardiol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"493","DOI":"10.3390\/jcm11030493","article-title":"Diminished endothelial function but normal vascular structure in adults with tetralogy of fallot","volume":"11","author":"Goeder","year":"2022","journal-title":"J. Clin. Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1703","DOI":"10.1161\/CIRCULATIONAHA.117.027402","article-title":"Immediate and midterm cardiac remodeling after surgical pulmonary valve replacement in adults with repaired tetralogy of fallot: a prospective cardiovascular magnetic resonance and clinical study","volume":"136","author":"Heng","year":"2017","journal-title":"Circulation"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.1007\/s00246-015-1143-3","article-title":"The effects of pulmonary valve replacement for severe pulmonary regurgitation on exercise capacity and cardiac function","volume":"36","author":"Ho","year":"2015","journal-title":"Pediatr. Cardiol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"e13049","DOI":"10.1111\/eci.13049","article-title":"Pulse wave velocity to global longitudinal strain ratio in hypertension","volume":"49","author":"Ikonomidis","year":"2019","journal-title":"Eur. J. Clin. Invest."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1386","DOI":"10.1093\/eurheartj\/ehr461","article-title":"Reference values for exercise limitations among adults with congenital heart disease. Relation to activities of daily life--single centre experience and review of published data","volume":"33","author":"Kempny","year":"2012","journal-title":"Eur. Heart J."},{"key":"B16","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1111\/apha.12904","article-title":"Isolated pulmonary regurgitation causes decreased right ventricular longitudinal function and compensatory increased septal pumping in a porcine model","volume":"221","author":"Kopic","year":"2017","journal-title":"Acta Physiol. (Oxf)"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.1016\/j.jacc.2013.03.085","article-title":"Ventricular-arterial coupling, remodeling, and prognosis in chronic heart failure","volume":"62","author":"Ky","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"e028766","DOI":"10.1161\/jaha.122.028766","article-title":"Left ventricular Physiology and ventricular-vascular interactions in young patients after heart transplantation","volume":"12","author":"Latus","year":"2023","journal-title":"J. Am. Heart Assoc."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.3390\/biomedicines9081007","article-title":"Clinical relevance of the sympathetic-vascular interactions in Health and disease","volume":"9","author":"Quarti-Trevano","year":"2021","journal-title":"Biomedicines"},{"key":"B20","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1111\/chd.12207","article-title":"Cardiorespiratory response to exercise before and after pulmonary valve replacement in patients with repaired tetralogy of fallot: a retrospective study and systematic review of the literature","volume":"10","author":"Sabate Rotes","year":"2015","journal-title":"Congenit. Heart Dis."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1889","DOI":"10.1161\/circulationaha.118.037064","article-title":"Substantial cardiovascular morbidity in adults with lower-complexity congenital heart disease","volume":"139","author":"Saha","year":"2019","journal-title":"Circulation"},{"key":"B22","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1016\/j.cardfail.2013.05.001","article-title":"Endothelial dysfunction is a marker of systemic response to the cardiac resynchronization therapy in heart failure","volume":"19","author":"Santini","year":"2013","journal-title":"J. Card. Fail"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1007\/s00380-019-01385-2","article-title":"Atrial septal defect and patent foramen ovale: early and long-term effects on endothelial function after percutaneous occlusion procedure","volume":"34","author":"Scicchitano","year":"2019","journal-title":"Heart Vessels"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e008493","DOI":"10.1161\/CIRCIMAGING.118.008493","article-title":"Noninvasive quantification of pressure-volume loops from brachial pressure and cardiovascular magnetic resonance","volume":"12","author":"Seemann","year":"2019","journal-title":"Circ. Cardiovasc Imaging"},{"key":"B25","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1067\/mtc.2001.115424","article-title":"Assessment of cardiovascular dynamics by pressure-area relations in pediatric patients with congenital heart disease","volume":"122","author":"Senzaki","year":"2001","journal-title":"J. Thorac. Cardiovasc Surg."},{"key":"B26","doi-asserted-by":"publisher","first-page":"4066","DOI":"10.1007\/s00330-018-5385-3","article-title":"Disturbed left and right ventricular kinetic energy in patients with repaired tetralogy of Fallot: pathophysiological insights using 4D-flow MRI","volume":"28","author":"Sjoberg","year":"","journal-title":"Eur. Radiol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"H345","DOI":"10.1152\/ajpheart.00417.2019","article-title":"Changes in left and right ventricular longitudinal function after pulmonary valve replacement in patients with Tetralogy of Fallot","volume":"318","author":"Sjoberg","year":"2020","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1111\/cpf.12718","article-title":"Non-invasive quantification of pressure-volume loops from cardiovascular magnetic resonance at rest and during dobutamine stress","volume":"41","author":"Sjoberg","year":"2021","journal-title":"Clin. Physiol. Funct. Imaging"},{"key":"B29","doi-asserted-by":"publisher","first-page":"H1691","DOI":"10.1152\/ajpheart.00330.2018","article-title":"Altered biventricular hemodynamic forces in patients with repaired tetralogy of Fallot and right ventricular volume overload because of pulmonary regurgitation","volume":"315","author":"Sjoberg","year":"","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"H895","DOI":"10.1152\/ajpheart.00483.2013","article-title":"The relationship between longitudinal, lateral, and septal contribution to stroke volume in patients with pulmonary regurgitation and healthy volunteers","volume":"306","author":"Stephensen","year":"2014","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"2077","DOI":"10.1007\/s10554-019-01647-0","article-title":"Transcatheter closure of atrial septal defect in adults: time-course of atrial and ventricular remodeling and effects on exercise capacity","volume":"35","author":"Stephensen","year":"2019","journal-title":"Int. J. Cardiovasc Imaging"},{"key":"B32","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1111\/cpf.12491","article-title":"Alterations in ventricular pumping in patients with atrial septal defect at rest, during dobutamine stress and after defect closure","volume":"38","author":"Stephensen","year":"2018","journal-title":"Clin. Physiol. Funct. Imaging"},{"key":"B33","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1510\/icvts.2004.101451","article-title":"Atrial septal defect in adults: echocardiography and cardiopulmonary exercise capacity associated with hemodynamics before and after surgical closure","volume":"4","author":"Suchon","year":"2005","journal-title":"Interact. Cardiovasc Thorac. Surg."},{"key":"B34","doi-asserted-by":"publisher","first-page":"H498","DOI":"10.1152\/ajpheart.1979.236.3.H498","article-title":"Total mechanical energy of a ventricle model and cardiac oxygen consumption","volume":"236","author":"Suga","year":"1979","journal-title":"Am. J. Physiol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1161\/01.res.32.3.314","article-title":"Load independence of the instantaneous pressure-volume ratio of the canine left ventricle and effects of epinephrine and heart rate on the ratio","volume":"32","author":"Suga","year":"1973","journal-title":"Circulation Res."},{"key":"B36","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1161\/01.res.56.4.586","article-title":"Optimal arterial resistance for the maximal stroke work studied in isolated canine left ventricle","volume":"56","author":"Sunagawa","year":"1985","journal-title":"Circ. Res."},{"key":"B37","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1007\/s00380-014-0475-x","article-title":"Brachial artery diameter has a predictive value in the improvement of flow-mediated dilation after aortic valve replacement for aortic stenosis","volume":"30","author":"Takata","year":"2015","journal-title":"Heart Vessels"},{"key":"B38","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/1532-429x-10-55","article-title":"Percutaneous closure of atrial septal defects leads to normalisation of atrial and ventricular volumes","volume":"10","author":"Teo","year":"2008","journal-title":"J. Cardiovasc Magn. Reson"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1312","DOI":"10.1253\/circj.CJ-20-0136","article-title":"Preoperative threshold for normalizing right ventricular volume after transcatheter closure of adult atrial septal defect","volume":"84","author":"Umemoto","year":"2020","journal-title":"Circ. J."},{"key":"B40","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4419-6363-5","volume-title":"Snapshots of hemodynamics","author":"Westerhof","year":"2010"},{"key":"B41","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1017\/S1047951117001457","article-title":"Additional mechanism for left ventricular dysfunction: chronic pulmonary regurgitation decreases left ventricular preload in patients with tetralogy of Fallot","volume":"28","author":"Ylitalo","year":"2018","journal-title":"Cardiol. Young"},{"key":"B42","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1007\/s00380-020-01741-7","article-title":"Late recovery of the cardiopulmonary exercise capacity after transcatheter amplatzer device closures for atrial septal defects in adults","volume":"36","author":"Yoshiba","year":"2021","journal-title":"Heart Vessels"}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2023.1291119\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T08:09:07Z","timestamp":1701850147000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2023.1291119\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,6]]},"references-count":42,"alternative-id":["10.3389\/fphys.2023.1291119"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2023.1291119","relation":{},"ISSN":["1664-042X"],"issn-type":[{"type":"electronic","value":"1664-042X"}],"subject":[],"published":{"date-parts":[[2023,12,6]]},"article-number":"1291119"}}