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Published on: May 11, 2015
Diastolic forward blood flow in the pulmonary arteries of normal children: a Doppler echocardiographic study
1Department of Pediatric Cardiology, Istanbul University Institute of Cardiology, Turkey.
Insights
This study establishes normal pulmonary arterial flow patterns in children using Doppler ultrasound. These findings provide essential reference values for diagnosing pediatric pulmonary conditions.
Area of Science:
- Pediatric Cardiology
- Medical Imaging
- Hemodynamics
Background:
- Assessing pulmonary arterial flow is crucial for diagnosing pediatric cardiovascular diseases.
- Normal reference values for pulmonary arterial flow in children are not well-established using Doppler echocardiography.
Purpose of the Study:
- To define normal Doppler ultrasound-derived pulmonary arterial flow velocities, flow velocity integrals, and flow duration during diastole in healthy children.
- To establish reference ranges for these hemodynamic parameters in a pediatric population.
Main Methods:
- Pulsed Doppler echocardiography was used to examine pulmonary arterial flow in 60 healthy children (age range 3.3–17.9 years).
- Measurements included peak velocities, flow velocity integrals, and duration of early and late diastolic antegrade flow.
- The influence of respiration on flow parameters was assessed in a subset of subjects.
Main Results:
- Two distinct antegrade diastolic waveforms were identified with specific velocity, integral, and duration ranges.
- No significant age-related differences were observed between younger (3–9 years) and older (9.1–18 years) children.
- Late diastolic forward flow velocities were significantly higher during inspiration compared to expiration (p = 0.001).
Conclusions:
- This study provides normative data for pulmonary arterial flow in children, essential for clinical interpretation.
- These reference values can aid in the diagnosis and management of pediatric pulmonary and cardiovascular diseases.
- Doppler echocardiography is a valuable tool for non-invasively assessing pulmonary hemodynamics in children.
Abstract:
Pulmonary arterial flow was examined in 60 normal children with a mean age of 8.5 +/- 3.7 years (range 3.3 to 17.9 years) and mean body surface area of 0.95 +/- 0.3 m2 (range 0.6 m2 to 1.7 m2) by pulsed Doppler echocardiography. Two distinct antegrade waveforms during diastole were detected. The peak velocities of early diastolic forward flow ranged from 20 to 30 cm/s (mean 26 +/- 4) and the late diastolic forward flow ranged from 16 to 29 cm/s (mean 23 +/- 3). The integrals of early diastolic forward flow ranged from 2.1 to 4.7 cm (mean 3.1 +/- 0.7) and late diastolic forward flow ranged from 1 to 3.6 cm (mean 2.1 +/- 0.7). Duration of early diastolic forward flow ranged from 161 to 256 ms (mean 187 +/- 29) and late diastolic forward flow ranged from 82 to 188 ms (mean 133 +/- 29). Data analysis for age indicated no significant difference in these measurements between children three to nine years old (n = 33) and children 9.1 to 18 years old (n = 27). The effect of respiration was observed in 10 randomly chosen subjects (mean age 8.6 +/- 4.1 years). Although early and late diastolic peak forward flow velocities, flow velocity integrals and flow duration during inspiration tended to be larger than during expiration, only late diastolic peak forward flow velocities during inspiration were significantly larger than during expiration (24.2 +/- 3.2 versus 18.2 +/- 3 cm/s, p = 0.001). This study defines normal Doppler ultrasound pulmonary arterial flow velocities, flow velocity integrals and flow duration during diastole in normal children. These results can be used for comparison with patterns found in disease states.
