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Color M-mode and Doppler tissue evaluation of diastolic function in children: simultaneous correlation with invasive
William L Border1, Erik C Michelfelder, Betty J Glascock
1Cincinnati Children's Hospital Medical Center, OH 45229-3039, USA. William.Border@chmcc.org
Insights
New Doppler indices show promise for assessing pediatric diastolic function noninvasively. These advanced echocardiographic methods correlate well with invasive measures, offering a valuable tool for evaluating heart function in children.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Diastolic Function Assessment
Background:
- Diastolic dysfunction is challenging to assess noninvasively in children.
- Traditional echocardiographic methods have limitations in pediatric populations.
Purpose of the Study:
- To validate novel diastolic indices from color M-mode Doppler and Doppler tissue imaging.
- To compare these noninvasive indices with invasive measurements of diastolic function in pediatric patients.
Main Methods:
- Simultaneous echocardiography and left ventricular (LV) pressure tracings in 20 children undergoing cardiac catheterization.
- Utilized transmitral Doppler, pulmonary vein Doppler, Doppler tissue imaging, and color M-mode Doppler flow propagation velocity.
- Compared echocardiographic data with invasive LV peak negative dP/dt, time constant of isovolumic relaxation, and LV end-diastolic pressure.
Main Results:
- Peak E-wave mitral velocity/propagation velocity ratio significantly correlated with LV end-diastolic pressure (r=0.71).
- Propagation velocity showed significant correlations with the time constant of isovolumic relaxation (r=-0.56) and peak negative dP/dt (r=0.50).
- Septal mitral annular myocardial velocity correlated significantly with the time constant of isovolumic relaxation (r=-0.58).
Conclusions:
- Color M-mode Doppler and Doppler tissue imaging-derived diastolic indices are valuable noninvasive tools.
- These novel indices aid in assessing pediatric diastolic function.
- The findings support the use of these advanced echocardiographic techniques in pediatric cardiology.
Objective:
The purpose of this study was to explore the validity of diastolic indices derived from color M-mode Doppler and Doppler tissue imaging in a heterogeneous group of pediatric patients by comparing them with simultaneously obtained invasive indices of diastolic function.
Methods:
A total of 20 children undergoing left heart catheterization had echocardiographic images recorded simultaneously with high-fidelity left ventricular (LV) pressure tracings. Transmitral Doppler, pulmonary vein Doppler, Doppler tissue imaging, and color M-mode Doppler flow propagation velocity were recorded. LV peak negative dP/dt, the time constant of isovolumic relaxation, and LV end-diastolic pressure were compared with the echocardiographic indices.
Results:
The ratio of peak E-wave mitral velocity/propagation velocity correlated significantly with LV end-diastolic pressure (r = 0.71; P <.001). Propagation velocity correlated with the time constant of isovolumic relaxation (r = -0.56; P =.01) and peak negative dP/dt (r = 0.50; P <.03). Septal mitral annular myocardial velocity correlated significantly with the time constant of isovolumic relaxation (r = -0.58, P =.01).
Conclusion:
The newer diastolic indices derived from color M-mode Doppler and Doppler tissue imaging appear to be a helpful adjunct in the noninvasive assessment of diastolic function in children.