Longitudinal motion of the atrioventricular annuli in children: reference values, growth related changes, and effects...

Area of Science:

• Cardiology
• Pediatric Echocardiography
• Cardiac Mechanics

Background:

• Understanding normal atrioventricular annulus motion is crucial for diagnosing pediatric cardiac conditions.
• Growth-related changes in annular dynamics are not well-characterized.
• Assessing the impact of volume and pressure overload on annular motion is important in congenital and acquired heart diseases.

Purpose of the Study:

• To characterize normal longitudinal motion patterns of atrioventricular annuli in children.
• To establish reference values for annular motion and assess growth-related changes.
• To evaluate the sensitivity of annular dynamics to changes in right ventricular volume and pressure load in patients with atrial septal defect (ASD) and primary pulmonary hypertension (PPH).

Main Methods:

• M-mode echocardiography was used to obtain images of the atrioventricular annuli from apical views.
• Longitudinal motion parameters, including %displacement and velocities of descent and ascent, were measured.
• Data were analyzed in healthy children and in pediatric patients with ASD and PPH.

Main Results:

• In healthy children, longitudinal %displacement decreased with growth, with the lateral tricuspid annulus showing the highest %displacement and velocity of descent.
• Ascent velocity of the lateral tricuspid annulus decreased with growth, while other ascent velocities remained similar.
• Patients with ASD showed an exaggerated normal pattern, while those with PPH exhibited blunted %displacement and ascent velocities.

Conclusions:

• This echocardiographic technique effectively assesses atrioventricular annular dynamics in pediatric patients.
• Reference values and growth-related changes in annular motion were established for healthy children.
• Abnormal annular dynamics were observed in pediatric patients with ASD and PPH, highlighting the clinical utility of this method.