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Causas de intolerancia al esfuerzo en el pectus excavatum;
Causes of Exercise Intolerance in Pectus Excavatum

Creators:Raggio, Ignacio M.; Staff servicio de cocardiografia CEMIC.
Jefe Servicio de ecocardiografia y Doppler Cardiaco Clínica Olivos y Clínica Zavala, SMG., Munin, Martín, Spernanzoni, Fernando, Thierer, Jorge, Torres, Víctor, Martínez Ferro, Marcelo, Bellia Munzón, Gastón, Vallejos, Javier
2017-03-14

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Descripción

Introducción: En múltiples estudios se ha determinado menor capacidad de esfuerzo en pacientes con pectus excavatum, pese a lo cual no se ha logrado demostrar claramente un mecanismo fisiopatológico que la explique. Objetivo: Evaluar la hemodinamia cardíaca y la función sistodiastólica en reposo y en esfuerzo en pacientes con pectus excavatum, comparándolos con controles sanos. Material y métodos: Se estudiaron con eco estrés 111 sujetos portadores de pectus excavatum y 20 controles sanos. Resultados: El diámetro mínimo a nivel del tracto de entrada del ventrículo derecho fue menor en los pacientes con pectus excavatum: 1,29 ± 0,26 cm/m2 versus 1,89 ± 0,25 cm/m2 (p &lt; 0,01). La capacidad de esfuerzo máxima fue menor en los pacientes con pectus excavatum: 8,3 ± 1,4 MET versus 15 ± 4,5 MET (p &lt; 0,0001). Se observaron signos de disfunción diastólica del ventrículo izquierdo en el 34,6% de los pacientes con pectus excavatum y en el 5% de los controles sanos (p = 0,007), y de disfunción diastólica del ventrículo derecho en el 40% de los portadores de pectus excavatum y el 15% de los controles sanos (p = 0,04). El gradiente tricuspídeo medio en el esfuerzo fue mayor en los pacientes con pectus excavatum: 6,21 ± 2,29 mm Hg versus 4,8 ± 1,17 mm Hg en los controles sanos (p = 0,01). El área tricuspídea en el esfuerzo se mantuvo fija en los portadores de pectus excavatum: 1,48 ± 0,57 cm2/m2 versus 2,11 ± 0,88 cm2/m2 en los controles sanos (p = 0,0001). Conclusiones: Los pacientes con pectus excavatum presentan alteraciones funcionales, probablemente producto de la compresión cardíaca externa, que se evidencian por un diámetro del anillo tricuspídeo menor, un gradiente diastólico tricuspídeo mayor en el esfuerzo, un área tricuspídea fija en reposo y en esfuerzo, y signos que sugieren disfunción diastólica del ventrículo izquierdo y el ventrículo derecho. Dichas alteraciones contribuyen a explicar la menor performance en el esfuer

Background: Despite several studies have reported lower exercise capacity in patients with pectus excavatum, none of them could demonstrate a clear pathophysiology. Objective: The aim of this study is to evaluate cardiac hemodynamics and systolic and diastolic function at rest and during exercise in patients with pectus excavatum and compare it with healthy controls. Methods: Stress echocardiography was performed in 111 subjects with pectus excavatum and 20 healthy controls. Results: Patients with pectus excavatum had lower right ventricular inflow minimum diameter: 1.29±0.26 cm/m2 versus 1.89±0.25 cm/m2 (p &lt;0.01). Peak exercise capacity was lower in patients with pectus excavatum: 8.3±1.4 METs versus 15±4.5 METs (p &lt;0.0001). Left ventricular diastolic dysfunction was observed in 34.6% of the patients with pectus excavatum and in 5% of the healthy controls (p=0.007), while 40% of the subjects with pectus excavatum and 15% of the healthy controls presented right ventricular diastolic dysfunction (p=0.04). Medium tricuspid pressure gradient during exercise was higher in patients with pectus excavatum: 6.21±2.29 mm Hg versus 4.8±1.17 mm Hg in healthy controls (p=0.01). The tricuspid valve area remained fixed during exercise in patients with pectus excavatum: 1.48±0.57 cm2/m2 versus 2.11±0.88 cm2/m2 in healthy controls (p=0.0001). Conclusions: Patients with pectus excavatum present functional abnormalities, probably due to external compression of the heart, which are evident by a small tricuspid annulus, a higher tricuspid pressure gradient during exercise, a tricuspid area

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 84, No 6 (2016); 543-547, Argentine Journal of Cardiology; Vol 84, No 6 (2016); 543-547

Citación

Raggio, Ignacio M.; Staff servicio de cocardiografia CEMIC. Jefe Servicio de ecocardiografia y Doppler Cardiaco Clínica Olivos y Clínica Zavala, SMG. et al., “Causas de intolerancia al esfuerzo en el pectus excavatum,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/9234.

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Materia

Autor

Raggio, Ignacio M.; Staff servicio de cocardiografia CEMIC.
Jefe Servicio de ecocardiografia y Doppler Cardiaco Clínica Olivos y Clínica Zavala, SMG.
Munin, Martín
Spernanzoni, Fernando
Thierer, Jorge
Torres, Víctor
Martínez Ferro, Marcelo
Bellia Munzón, Gastón
Vallejos, Javier

Fuente

Revista Argentina de Cardiología; Vol 84, No 6 (2016); 543-547
Argentine Journal of Cardiology; Vol 84, No 6 (2016); 543-547

Editor

Sociedad Argentina de Cardiología

Fecha

2017-03-14

Colaborador

CEMIC

Derechos

Los que firman al pié, certificamos que tenemos total responsabilidad por la conducción de este estudio y por el diseño y la interpretación de los datos. Nosotros escribimos el manuscrito y somos responsables por la decisión acerca del mismo. Cada uno de nosotros cumple la definición de autor como se afirma en el Comité Internacional de Editores de Revistas Médicas (International Committee of Medical Journal Editors, ver www.icmje.org). Nosotros hemos visto y aprobado el manuscrito final. Ni el artículo, ni ninguna parte esencial del mismo, incluido las tablas y las figuras, será publicado o admitido para arbitrar a otra parte antes de aparecer en la Revista.También notificamos haber leído la sección “conflicto de intereses”, y revelaríamos cualquiera que existiera. Dejamos constancia que si nuestro artículo se publicara en la RAC, cederíamos los derechos (copyright) a la Revista.Los documentos publicados en esta revista están bajo la licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.
Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

Formato

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spa
eng

Tipo

info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion