Right ventricular diastolic filling assessed by conventional doppler and tissue Doppler imaging in normal children
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Published on: December 13, 2019
Insights
Right ventricular filling dynamics mature with age, showing significant changes in early diastolic function. These age-related alterations in tricuspid inflow and myocardial velocities suggest developing right ventricular diastolic performance in children.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Echocardiography
Background:
- Right ventricular (RV) diastolic function is crucial for overall cardiac performance.
- Understanding age-related changes in RV filling dynamics is essential for diagnosing pediatric cardiac conditions.
- Limited data exists on the normative development of RV diastolic function across a wide pediatric age range.
Purpose of the Study:
- To investigate age-related changes in right ventricular (RV) diastolic filling dynamics using conventional pulsed Doppler and tissue Doppler echocardiography.
- To establish normative reference values for RV diastolic parameters throughout childhood and adolescence.
- To correlate RV inflow patterns with myocardial relaxation velocities to assess RV diastolic maturation.
Main Methods:
- Conventional pulsed Doppler and tissue Doppler echocardiography were performed in 99 and 30 normal subjects, respectively.
- Subjects ranged in age from 7 days to 273 months (22.75 years).
- Tricuspid inflow velocities (peak E) and RV tissue Doppler velocities (peak E and A) were analyzed and correlated with age.
Main Results:
- Tricuspid peak E wave velocity showed a significant, albeit weak, correlation with the logarithm of age.
- Peak E wave velocity increased from approximately 80% of adult values in neonates to 100% by 36 months.
- RV tissue Doppler peak E velocity also increased significantly with age, mirroring tricuspid inflow patterns.
Conclusions:
- Age-related maturation of right ventricular diastolic performance is evident in children and adolescents.
- Conventional and tissue Doppler echocardiography can effectively assess these age-related changes in RV diastolic function.
- Findings provide normative data for evaluating RV diastolic function across the pediatric age spectrum.
Abstract:
To examine age-related changes in right ventricular filling dynamics, we performed conventional pulsed Doppler (n=99) and tissue Doppler (n=30) echocardiographic studies in normal subjects aged 7 days to 273 months. The tricuspid flow velocity during early diastole (peak E) wave correlated significantly but weakly with the logarithm of age. The peak E wave in the early neonatal period was almost 80% of the older children's values and increased to 100% by 36 months of age. In the right ventricular tissue Doppler imaging, the peak myocardial velocity during early diastole also increased significantly with the logarithm of age. However, the tissue Doppler peak A did not change with age. There was a significant correlation between the tissue Doppler peak E wave and the tricuspid peak E wave and between the tissue Doppler peak E/A wave and the tricuspid peak E/A wave. The age-related changes in the tricuspid inflow velocity patterns were similar to the age-related alterations in the right ventricular myocardial velocity patterns. Age-related changes in the tricuspid inflow velocity and myocardial velocity patterns may be related to age-related maturation in the right ventricular diastolic performance.
