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Characterization of left ventricular diastolic function by tissue Doppler imaging and clinical status in children
Colin J McMahon1, Sherif F Nagueh, Ricardo H Pignatelli
1Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Houston, Tex 77030, USA.
Circulation
|March 17, 2004
Summary
Tissue Doppler imaging can predict adverse outcomes in children with hypertrophic cardiomyopathy (HCM). The transmitral E/septal Ea ratio identifies those at risk for death, cardiac arrest, or ventricular tachycardia (VT).
Area of Science:
- Pediatric Cardiology
- Cardiovascular Imaging
- Hypertrophic Cardiomyopathy Research
Background:
- Conventional Doppler indices for hypertrophic cardiomyopathy (HCM) are unreliable due to loading condition variability.
- Tissue Doppler imaging offers a potential alternative for assessing clinical status in pediatric HCM patients.
Purpose of the Study:
- To determine if tissue Doppler velocities predict adverse clinical outcomes in children with HCM.
- To assess the predictive value for mortality, cardiac arrest, ventricular tachycardia (VT), symptoms, and exercise capacity.
Main Methods:
- Eighty children with HCM and 80 age/gender-matched controls were studied.
- Echocardiography, Holter monitoring, and upright exercise testing were performed.
- Tissue Doppler velocities and transmitral Doppler indices were analyzed.
Main Results:
- Children with HCM showed significantly decreased early diastolic tissue Doppler velocities compared to controls.
- The transmitral E/septal Ea ratio predicted death, cardiac arrest, or VT (r=0.610).
- Peak oxygen consumption (VO2) was most predictive of symptomatic children (r=0.427) and correlated inversely with E/Ea (r=-0.740).
Conclusions:
- The transmitral E/septal Ea ratio is a valuable predictor of adverse outcomes in pediatric HCM.
- Peak VO2 is correlated with exercise capacity in these patients.
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