Effects of Pulmonary Vascular Resistance Index on Oxygen Saturation in Patients with Atrial Septal Defect

Authors

DOI:

https://doi.org/10.21776/ub.jkb.2020.031.01.13

Keywords:

Atrial septal defect, oxygen saturation, pulmonary hypertension, PVRi

Abstract

Atrial septal defect (ASD) is a congenital lesion in atrium septum. The lesion may cause pulmonary hypertension due to the high pressure in the right ventricle. This condition leads to cyanosis in ASD patient, but the pathophysiology of cyanosis in ASD patient is still unknown. This study aimed to identify the pathophysiology of cyanosis in ASD patients using the Pulmonary Vascular Resistance index (PVRi). The design of this study was retrospective cohort study. The data used in this study were the results of right heart catheterization procedure taken from forty ASD patient medical records at Dr. Sardjito general hospital. The exclusions criteria were the history of previous vasodilator administration and incomplete medical records. The median age of the patients was 30 (18-55) years old. The mean of the Qp/Qs ratio was 1.210 (0.57-6.33). Optimum oxygen saturation was found in vessel leaving the heart. The PVRi median is 61.98 (-15.58-676.64). The PVRi has a significant correlation with oxygen saturation, except in the right atrium. There is a significant correlation between PVRi and oxygen saturation in various heart chambers. Pathophysiology of cyanosis in ASD patients is central cyanosis.

Downloads

Download data is not yet available.

Author Biography

Supomo Supomo, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada

Department of Thoracic and Cardiovascular Surgery

References

Post MC. Association between pulmonary hypertension and an atrial septal defect. Neth Heart J. 2013;331–2.

Alto MD, Romeo E, Argiento P, Correra A, Santoro G, Gaio G, et al. Hemodynamics of patients developing pulmonary arterial hypertension after shunt closure. Int J Cardiol [Internet]. Elsevier Ireland Ltd; 2013;168(4):3797–801. Available from: http://dx.doi.org/10.1016/j.ijcard.2013.06.036

Kuijpers JM, van der Bom T, van Riel ACMJ, Meijboom FJ, van Dijk APJ, Pieper PG, et al. Secundum atrial septal defect is associated with reduced survival in adult men. Eur Heart J [Internet]. Oxford University Press; 2015 Aug 14 [cited 2017 Nov 9];36(31):2079–86. Available from: https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehv097

Bruce JT, Daniels C, Sood N, The M, State O. Management of Atrial Septal Defect- Related Pulmonary Hypertension Using Epoprostenol and Percutaneous Closure. Chest. The American College of Chest Physicians; 2010;138(4):6A–1–6A–2.

Novira RY, Yosoprawoto M. Quality of Life in Children with Heart Disease. J Kedokt Brawijaya. 2012;27(1):56–60.

Das S, Maiti A. Acrocyanosis: an overview. Indian J Dermatol [Internet]. Wolters Kluwer -- Medknow Publications; 2013 Nov [cited 2017 Nov 9];58(6):417–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24249890

Geffroy-Perrin C, Geffroy C, Gentili ME. Application of nitroglycerin patch to treat finger cyanosis due to unintentional injection of epinephrine. Am J Emerg Med [Internet]. W.B. Saunders; 2017 Feb 1 [cited 2017 Nov 10];35(2):372.e5-372.e6. Available from: http://www.sciencedirect.com.ezproxy.ugm.ac.id/science/article/pii/S0735675716304727

Herbert S, If TD, Howard L, Tulloh RMR, If TD. Early Experience of Macitentan for Pulmonary Arterial Hypertension in Adult Congenital Heart Disease. Hear Lung Circ. Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ); 2017;1–4.

Suzuki H, Hanawa H, Torigoe T, Sato S. Improvement of pulmonary arterial hypertension following medication and shunt closure in a BMPR2 mutation carrier with atrial septal defect. J Cardiol Cases [Internet]. Elsevier; 2017 Jul 1 [cited 2017 Nov 10];16(1):11–3. Available from: http://www.sciencedirect.com.ezproxy.ugm.ac.id/science/article/pii/S1878540917300294

Krieger E V., Leary PJ, Opotowsky AR. Pulmonary Hypertension in Congenital Heart Disease. Beyond Eisenmenger Syndrome. Cardiol Clin [Internet]. Elsevier; 2015 Nov 1 [cited 2017 Nov 10];33(4):599–609. Available from: http://www.sciencedirect.com.ezproxy.ugm.ac.id/science/article/pii/S0733865115000727

Keller RL. Pulmonary Hypertension and Pulmonary Vas o d i l a t o r s. 2019;43(2016):187–202.

Giannakoulas G, Gatzoulis MA. Pulmonary arterial hypertension in congenital heart disease: Current perspectives and future challenges. Hell J Cardiol [Internet]. Elsevier; 2016 Jul 1 [cited 2017 Nov 10];57(4):218–22. Available from: http://www.sciencedirect.com.ezproxy.ugm.ac.id/science/article/pii/S1109966616301440

Titaram Y, Durongpisitkul K, Chanthong P, Kanjanauthai S, Soongswang J, Vijarnsorn C. Treatment and Survival of Atrial Septal Defect in Associated With Pulmonary Hypertension. Can J Cardiol [Internet]. Elsevier; 2015 Oct 1 [cited 2017 Nov 10];31(10):S125. Available from: http://www.sciencedirect.com.ezproxy.ugm.ac.id/science/article/pii/S0828282X15008211

Amsallem M, Boulate D, Aymami M. Load Adaptability in Patients With Pulmonary. Am J Cardiol. Elsevier Inc.; 2019;120(5):874–82.

Hascoët S, Baruteau A-E, Humbert M, Simonneau G, Jais X, Petit J, et al. Long-term outcomes of pulmonary arterial hypertension under specific drug therapy in Eisenmenger syndrome. J Hear Lung Transplant [Internet]. Elsevier; 2017 Apr 1 [cited 2017 Nov 10];36(4):386–98. Available from: http://linkinghub.elsevier.com/retrieve/pii/S1053249816303643

Downloads

Published

2020-02-29

Issue

Vol. 31 No. 1 (2020)

Section

Research Article

License

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).