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Study identifies underlying dysfunction of seemingly non-critical heart condition
Date:9/13/2010

lecular and cellular levels precede future dysfunction in these patients.

"Without clearly defined evidence supporting optimal care, clinicians are unable to predict which rVSD patients have an increased risk of a poor outcome," said Mark Gerhardt, MD, PhD, associate professor of Anesthesiology at the Ohio State University Medical Center and one of the study authors.

Using an animal model of rVSD, the team at Nationwide Children's Hospital and Ohio State University Medical Center discovered that although blood flow was normal in the models' heart, there were molecular changes, evidence of right ventricular diastolic dysfunction, and impairment of muscle contraction and relaxation at the cellular level.

"These data indicate that despite no overt dysfunction at the level of the whole heart, molecular remodeling and progressive diastolic dysfunction is nevertheless taking place," said Dr. Wold, also a faculty member at The Ohio State University College of Medicine.

"Right ventricular diastolic dysfunction in rVSD is a major finding of this study," said Dr. Gerhardt. "Because the right ventricle is a low-pressure system, small changes in right ventricular compliance may have significant clinical consequences. Our findings indicate that patients with rVSD should be carefully evaluated for right ventricular diastolic dysfunction."

The study also revealed upregulation of the cytoskeletal protein, desmin, in the wall of the right ventricle that precedes functional alterations.

"Desmin may represent a key early marker for future right ventricular dysfunction," said Dr. Wold. "Future research is warranted to determine if increased desmin is the cause or a reaction to diastolic dysfunction."

Findings from the study may lead to a fundamental change in the clinical management of rVSD by providing evidence for early repair of the defect.


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Contact: Mary Ellen Peacock
MaryEllen.Peacock@NationwideChildrens.org
614-355-0495
Nationwide Children's Hospital
Source:Eurekalert

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