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Apoptosis of Cardiomyocytes in Children with Right Ventricular Pressure Overload with and without Hypoxemia
Author(s) -
Tsang Flora Hau Fung,
Chow PakCheong,
Ma YuenYuen,
Man Kwan,
Cheng LikCheung,
Cheung YiuFai
Publication year - 2014
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12337
Subject(s) - medicine , inotrope , pressure overload , ventricle , tetralogy of fallot , hypoxemia , cardiology , apoptosis , ventricular pressure , ventricular remodeling , pulmonic stenosis , heart failure , stenosis , anesthesia , heart disease , blood pressure , biochemistry , chemistry , cardiac hypertrophy
Background Cardiomyocyte apoptosis has been implicated in ventricular remodeling and initiation of cardiac failure. We sought to determine the severity of right ventricular (RV) cardiomyocyte apoptosis in cyanotic and acyanotic children with RV pressure overload. Methods Fourteen patients, seven with tetralogy of Fallot (group I) and seven with pulmonary stenosis and ventricular septal defect (group II), undergoing open‐heart surgery were studied. Right ventricular biopsies were examined for cardiomyocyte apoptosis by terminal deoxynucleotide transferase‐mediated dUTP nick‐end labeling. The magnitude of cardiomyocyte apoptosis was related to preoperative oxygen saturation and postoperative inotrope use and hospital stay. Results Compared with group I patients, group II patients were significantly older at operation (p = 0.002) and had a larger body size (p < 0.01) and higher preoperative oxygen saturation (p = 0.01). The prevalence of cardiomyocyte apoptosis in both group I and II patients as a whole was 0.24 ± 0.29% (range, 0% to 1.10%). The prevalence was similar between group I (median 0.30%, range 0% to 1.10%) and group II (median 0.20, range 0% to 0.40%, p = 0.65). The prevalence of cardiomyocyte apoptosis correlated positively with preoperative oxygen saturation on room air (r = −0.69, p < 0.005) and postoperative inotrope score (r = 0.67, p = 0.001). A higher postoperative inotrope score (r = 0.68, p = 0.001) was associated with a significant longer duration of postoperative stay in the hospital. Conclusions The prevalence of cardiomyocyte apoptosis in the pressure‐overloaded right ventricle is related to the severity of hypoxia and may have an impact on postoperative course in terms of early postoperative use of inotropes and duration of hospital stay. doi: 10.1111/jocs.12337 (J Card Surg 2014;29:531–536)