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Usefulness of tissue Doppler echocardiography for evaluating ventricular function in children without heart disease
Sethuraman Swaminathan1, Peter L Ferrer, Grace S Wolff
1Department of Pediatrics, University of Miami/Jackson Memorial Medical Center, Florida 33101, USA. sswami@med.miami.edu
Insights
Tissue Doppler echocardiography (TDI) effectively assesses pediatric ventricular function, especially diastolic function. Establishing normative TDI data in children aged 1-18 years enhances its clinical use.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Cardiovascular Physiology
Background:
- Tissue Doppler echocardiography (TDI) is a novel method for evaluating ventricular function.
- Limited data exist on TDI index distribution in healthy children (1-18 years).
Purpose of the Study:
- Assess TDI index distribution for systolic and diastolic ventricular function in healthy children.
- Evaluate the influence of age on these TDI indexes.
- Compare TDI indexes with conventional Doppler indexes.
Main Methods:
- 151 healthy children (1-18 years) underwent echocardiography.
- Nine TDI parameters (7 diastolic, 2 systolic) were assessed.
- Measurements included annular velocities and posterior wall relaxation velocity.
Main Results:
- Significant differences in some TDI indexes were observed across pediatric age groups.
- Most TDI indexes showed weak correlation with age.
- Significant correlation found between tricuspid annulus TDI and Doppler indexes, unlike mitral inflow (E wave).
Conclusions:
- TDI is valuable for assessing ventricular function, particularly diastolic function, in children.
- Establishing normative TDI data in pediatrics will expand its clinical application.
- TDI provides crucial insights into pediatric cardiac health.
Abstract:
Tissue Doppler echocardiographic imaging (TDI) is a novel method for accurately evaluating ventricular function. Currently, scant data are available on the distribution of tissue Doppler indexes in healthy children in the age range of 1 to 18 years. The aims of this study were to assess the distribution of tissue Doppler indexes of systolic and diastolic ventricular function in healthy children, to assess the influence of age on these indexes, and to compare them with conventional Doppler indexes. A total of 151 consecutive children aged 1 to 18 years were enrolled in the study. Nine different (7 diastolic and 2 systolic) TDI parameters were assessed. Peak velocities of systolic and diastolic excursions of the mitral and tricuspid annuli were obtained from the apical 4-chamber view. Mean velocities of early diastolic recoil of mitral and tricuspid annuli were measured from the apical 4-chamber view. The mean velocity of early diastolic relaxation of the left ventricular posterior wall was measured in the parasternal long-axis view. Results showed a statistically significant difference in some of the TDI indexes among the different pediatric age groups. Most of the TDI indexes showed a very weak correlation with age. There was no significant correlation (p >0.05) between peak velocities of the early diastolic mitral inflow Doppler pattern (E wave) and the corresponding TDI index. In contrast, there was a significant (p <0.001) correlation between the corresponding Doppler indexes in the tricuspid annulus. We conclude that TDI is a valuable tool for assessing ventricular function, particularly diastolic function. Establishment of normative data for TDI in the pediatric age group should broaden the clinical applicability of this useful modality for assessing ventricular function.