To better understand the hemodynamics of pulmonary stenosis (PS), 24 adults and 53 children with similar degrees of PS who had undergone cardiac catheterization at rest and during supine exercise were retrospectively studied. Three groups were defined. Group I consisted of 9 adults and 18 children with a pulmonary valve area of less tjan 0.5 cm2/m2; group II, 6 adults and 25 children with a pulmonary valve area of 0.5 to 1.0 cm2/m2; and group III, 9 adults and 10 children with pulmonary valve area of more than 1.0 cm2/m2. The mean ages of the adults were 29, 26 and 22 years for groups I, II, and III, respectively. The mean ages of the children were 11, 10 and 9 years for groups I, II and III, respectively. The pertinent data collected from catheterization included oxygen consumption, cardiac rate and index, arterial venous oxygen difference, stroke index, right ventricular (RV) systolic pressure and RV end-diastolic pressure. Adults and children in groups II and III had a appropriate response to exercise. Group I children responded abnormally by increasing their RV end-diastolic pressure and decreasing their stroke index. In group I adults both of these variables increased. Group I adults exhibited a significantly lower cardiac index at rest and exercise secondary to a significantly lower absolute cardiac rate. Long-standing severe PS results in hemodynamic compromise. Hence, early relief of PS is recommended.
|Original language||English (US)|
|Number of pages||6|
|Journal||The American Journal of Cardiology|
|State||Published - Aug 1 1985|
Bibliographical noteFunding Information:
From the Departments of Pediatrics and Medicine, University of Minnesota, Minneapolis, Minnesota. This study was supported in part by the Minnesota Medical Foundation and the Paul F. Dwan Professorship in Pediatric Cardiology, University of Minnesota, Minneapolis, Minnesota. Manuscript received October 22, 1984; revised manuscript received March 26, 1985, accepted March 27, 1985. Address for reprints: James H. Moller, MD, Professor of Pediatrics, BOX 288, University of Minnesota Hospitals, 420 Delaware Street, S.E., Minneapolis, Minnesota 55455.