Pulmonary Arterial Wall Stiffness and Its Impact on Right Ventricular Afterload in Patients With Repaired Tetralogy of Fallot Ryo Inuzuka, MD, PhD, Mitsuru.

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Pulmonary Arterial Wall Stiffness and Its Impact on Right Ventricular Afterload in Patients With Repaired Tetralogy of Fallot Ryo Inuzuka, MD, PhD, Mitsuru Seki, MD, Masaya Sugimoto, MD, PhD, Hirofumi Saiki, MD, PhD, Satoshi Masutani, MD, PhD, Hideaki Senzaki, MD, PhD The Annals of Thoracic Surgery Volume 96, Issue 4, Pages 1435-1441 (October 2013) DOI: 10.1016/j.athoracsur.2013.05.085 Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Difference in pulmonary arterial input impedance between patients with tetralogy of Fallot (TOF) and the control group. Z1 to Z5 denote the impedance at the first to fifth harmonics. Zc indicates the characteristic impedance, calculated by averaging all impedance moduli between 3 and 10 Hz. Error bars indicate the range of the standard error of the mean. The figure shows elevated pulmonary arterial stiffness (Zc) and pulsatile load (Z1) in patients with TOF. The Annals of Thoracic Surgery 2013 96, 1435-1441DOI: (10.1016/j.athoracsur.2013.05.085) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Averaged pulmonary arterial pressure waveforms in patients with tetralogy of Fallot (TOF) and in controls. The figure shows enhanced reflection in (A) patients with TOF compared with (B) the control group. (Pb = backward pressure [dotted line]; Pf = forward pressure [dashed line]; Pm = measured pressure value [solid line].) The Annals of Thoracic Surgery 2013 96, 1435-1441DOI: (10.1016/j.athoracsur.2013.05.085) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Impact of pulmonary arterial wall stiffness on the right ventricular (RV) end-diastolic volume in patients with tetralogy of Fallot. Significant correlations between RV end-diastolic volume and pulmonary arterial compliance were observed among patients with moderate or severe pulmonary regurgitation (closed circles) and patients without moderate or severe pulmonary regurgitation (open circles). The Annals of Thoracic Surgery 2013 96, 1435-1441DOI: (10.1016/j.athoracsur.2013.05.085) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions