Effect Of Pulmonary Stenosis Research Articles

Effect of pulmonary stenosis on pregnancy outcomes—A case-control study

Pulmonary stenosis (PS) accounts for 10% to 12% of congenital heart disease in adults, and the probability of survival to child bearing age is high. The impact of PS on pregnancy has not been extensively studied in the recent era. We evaluate the effect of isolated PS on maternal and fetal outcomes in a case-control study of 17 cases with PS in pregnancy from 1995 to 2006. The control group was matched by age, ethnicity, obstetrical history, and year of delivery. Patients with PS were assessed for maternal New York Heart Association (NYHA) functional class and other maternal complications at baseline and during pregnancy; and the 2 groups were compared for fetal and neonatal outcomes including birth weight, gestational age at delivery, Apgar scores, and placental weight. A total of 11 patients were in NYHA functional class I and 6 in class II at the time of presentation. All patients remained stable during pregnancy except for two. One of them deteriorated from NYHA functional class I to II, and the other from class II transiently to class III. There were no other maternal complications. In addition, there were no statistically significant differences in fetal/neonatal outcomes between patients and their controls and between patients with mild and severe PS. In contrast to mitral and aortic stenosis, PS does not adversely impact maternal or fetal outcomes of pregnancy.

Pathogenesis of Cardiomyopathy Caused by Anthracycline Antibiotics: Effect of Pulmonary Stenosis on the Development of Cardiomyopathy

This study was undertaken to elucidate the effect of pressure load on the development of cardiomyopathy induced by daunorubicin in the right ventricle of rabbits on which pulmonary stenosis had been performed. The right ventricular pressure after occlusion of the pulmonary artery was approximately twice that prior to occlusion. Pulmonary stenosis apparently produced hypertrophy of the right ventricular myocardium within approximately 2 weeks of occlusion. In rabbits with pulmonary stenosis, the characteristic myocardial degenerative changes induced by daunorubicin were found on the right ventricular wall. However, in rabbits without pulmonary stenosis, myocardial lesions were observed only on the left ventricular wall. The pressure load acting as a mechanical stress increases myocardial damage induced by daunorubicin. It is well known that anthracyclines take effect on cells in which nucleic acid synthesis is augmented and the pressure load results in the enhancement of protooncogene expression in myocytes and a subsequent increase in protein synthesis. These results suggest that the pressure load may play a significant role in anthracycline cardiomyopathy by increasing protein synthesis in the myocardium.

Aorticopulmonary septal defect coexisting with ventricular septal defect.

Three cases, in each of which an aorticopulmonary septal defect (AP window) coexisted with a ventricular septal defect, are described. In two the ventricular septal defect was of the usual variety, and in one it was part of the tetralogy of Fallot. The patients presented as examples of congestive cardiac failure with a large left-to-right shunt in infancy. Aortography was the most reliable method for identification of the AP window when a ventricular septal defect was associated. Associated features included a right aortic arch with mirror image branching in the first case and tetralogy of Fallot with muscular subaortic stenosis in the third case. In the case with the tetralogy of Fallot, the effects of pulmonary stenosis were masked by the left-to-right shunt through the AP window.