Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Morphology and Function of the Lymphatic Vasculature in Patients With a Fontan Circulation

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Harvard

Mohanakumar, S, Telinius, N, Kelly, B, Lauridsen, H, Bødtkjer, DMB, Pedersen, M, de Leval, M & Hjortdal, VE 2019, 'Morphology and Function of the Lymphatic Vasculature in Patients With a Fontan Circulation', Circulation: Cardiovascular Imaging, bind 12, nr. 4, e008074. https://doi.org/10.1161/CIRCIMAGING.118.008074

APA

Mohanakumar, S., Telinius, N., Kelly, B., Lauridsen, H., Bødtkjer, D. M. B., Pedersen, M., de Leval, M., & Hjortdal, V. E. (2019). Morphology and Function of the Lymphatic Vasculature in Patients With a Fontan Circulation. Circulation: Cardiovascular Imaging, 12(4), [e008074]. https://doi.org/10.1161/CIRCIMAGING.118.008074

CBE

MLA

Vancouver

Author

Mohanakumar, Sheyanth ; Telinius, Niklas ; Kelly, Benjamin ; Lauridsen, Henrik ; Bødtkjer, Donna Marie Briggs ; Pedersen, Michael ; de Leval, Marc ; Hjortdal, Vibeke E. / Morphology and Function of the Lymphatic Vasculature in Patients With a Fontan Circulation. I: Circulation: Cardiovascular Imaging. 2019 ; Bind 12, Nr. 4.

Bibtex

@article{8195323dcfba4f198e6e270fe664b053,
title = "Morphology and Function of the Lymphatic Vasculature in Patients With a Fontan Circulation",
abstract = "BACKGROUND:The Fontan procedure has revolutionized the treatment of univentricular hearts. However, it is associated with severe complications such as protein-losing enteropathy, plastic bronchitis, and peripheral edema that may involve the lymphatic circulation. We aimed to assess lymphatic function and morphology in patients with a univentricular circulation.METHODS:The functional state of lymphatic vessels in the lower extremities of patients with a Fontan circulation (n=10) was investigated using the novel technique near-infrared fluorescence imaging and compared with an age-, sex-, and weight-matched control group of healthy volunteers (n=10). The lymphatic morphology was described using T2-weighted magnetic resonance imaging, and microvascular permeability was estimated by strain gauge plethysmography.RESULTS:The Fontan patients had 17% lower lymphatic pumping pressure (50±3.1 mm Hg) compared with controls (60±2.8 mm Hg; P=0.0341) and a 62% higher contraction frequency (0.8±0.1 min-1) compared with the healthy controls (0.5±0.1 min-1; P=0.0432). Velocity by which the lymph is moved and refill time after manual emptying of the lymphatic vessels showed no differences between the 2 groups. The thoracic duct was elongated 10% ( P=0.0409) and with an abnormal course in the Fontan patients compared with normal. No difference in microvascular permeability was found between the 2 groups.CONCLUSIONS:Patients with a Fontan circulation have an impaired lymphatic pumping capacity and morphologically changed thoracic duct. Our results indicate a challenged lymphatic vasculature in the Fontan circulation and may play a role in the pathogenesis of the complications that are seen in Fontan patients.",
author = "Sheyanth Mohanakumar and Niklas Telinius and Benjamin Kelly and Henrik Lauridsen and B{\o}dtkjer, {Donna Marie Briggs} and Michael Pedersen and {de Leval}, Marc and Hjortdal, {Vibeke E.}",
year = "2019",
month = apr,
doi = "10.1161/CIRCIMAGING.118.008074",
language = "English",
volume = "12",
journal = "Circulation: Cardiovascular Imaging",
issn = "1941-9651",
publisher = "Lippincott Williams & Wilkins",
number = "4",

}

RIS

TY - JOUR

T1 - Morphology and Function of the Lymphatic Vasculature in Patients With a Fontan Circulation

AU - Mohanakumar, Sheyanth

AU - Telinius, Niklas

AU - Kelly, Benjamin

AU - Lauridsen, Henrik

AU - Bødtkjer, Donna Marie Briggs

AU - Pedersen, Michael

AU - de Leval, Marc

AU - Hjortdal, Vibeke E.

PY - 2019/4

Y1 - 2019/4

N2 - BACKGROUND:The Fontan procedure has revolutionized the treatment of univentricular hearts. However, it is associated with severe complications such as protein-losing enteropathy, plastic bronchitis, and peripheral edema that may involve the lymphatic circulation. We aimed to assess lymphatic function and morphology in patients with a univentricular circulation.METHODS:The functional state of lymphatic vessels in the lower extremities of patients with a Fontan circulation (n=10) was investigated using the novel technique near-infrared fluorescence imaging and compared with an age-, sex-, and weight-matched control group of healthy volunteers (n=10). The lymphatic morphology was described using T2-weighted magnetic resonance imaging, and microvascular permeability was estimated by strain gauge plethysmography.RESULTS:The Fontan patients had 17% lower lymphatic pumping pressure (50±3.1 mm Hg) compared with controls (60±2.8 mm Hg; P=0.0341) and a 62% higher contraction frequency (0.8±0.1 min-1) compared with the healthy controls (0.5±0.1 min-1; P=0.0432). Velocity by which the lymph is moved and refill time after manual emptying of the lymphatic vessels showed no differences between the 2 groups. The thoracic duct was elongated 10% ( P=0.0409) and with an abnormal course in the Fontan patients compared with normal. No difference in microvascular permeability was found between the 2 groups.CONCLUSIONS:Patients with a Fontan circulation have an impaired lymphatic pumping capacity and morphologically changed thoracic duct. Our results indicate a challenged lymphatic vasculature in the Fontan circulation and may play a role in the pathogenesis of the complications that are seen in Fontan patients.

AB - BACKGROUND:The Fontan procedure has revolutionized the treatment of univentricular hearts. However, it is associated with severe complications such as protein-losing enteropathy, plastic bronchitis, and peripheral edema that may involve the lymphatic circulation. We aimed to assess lymphatic function and morphology in patients with a univentricular circulation.METHODS:The functional state of lymphatic vessels in the lower extremities of patients with a Fontan circulation (n=10) was investigated using the novel technique near-infrared fluorescence imaging and compared with an age-, sex-, and weight-matched control group of healthy volunteers (n=10). The lymphatic morphology was described using T2-weighted magnetic resonance imaging, and microvascular permeability was estimated by strain gauge plethysmography.RESULTS:The Fontan patients had 17% lower lymphatic pumping pressure (50±3.1 mm Hg) compared with controls (60±2.8 mm Hg; P=0.0341) and a 62% higher contraction frequency (0.8±0.1 min-1) compared with the healthy controls (0.5±0.1 min-1; P=0.0432). Velocity by which the lymph is moved and refill time after manual emptying of the lymphatic vessels showed no differences between the 2 groups. The thoracic duct was elongated 10% ( P=0.0409) and with an abnormal course in the Fontan patients compared with normal. No difference in microvascular permeability was found between the 2 groups.CONCLUSIONS:Patients with a Fontan circulation have an impaired lymphatic pumping capacity and morphologically changed thoracic duct. Our results indicate a challenged lymphatic vasculature in the Fontan circulation and may play a role in the pathogenesis of the complications that are seen in Fontan patients.

UR - https://www.ncbi.nlm.nih.gov/pubmed/30943769

U2 - 10.1161/CIRCIMAGING.118.008074

DO - 10.1161/CIRCIMAGING.118.008074

M3 - Journal article

C2 - 30943769

VL - 12

JO - Circulation: Cardiovascular Imaging

JF - Circulation: Cardiovascular Imaging

SN - 1941-9651

IS - 4

M1 - e008074

ER -

ID: 65027347