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Updated: Jun 10, 2026
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Evaluation of right ventricle function in children with primary nephrotic syndrome
Qiang Qin1, Ruiying Xu, Junhua Dong
1Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China. qin-qiang@126.com
Insights
Right ventricle function is impaired in children with primary nephrotic syndrome (PNS), showing increased filling pressures and reduced ejection fraction. These changes may correlate with elevated tumor necrosis factor-alpha (TNF-alpha).
Area of Science:
- Pediatric Cardiology
- Nephrology
- Cardiovascular Physiology
Background:
- Primary nephrotic syndrome (PNS) is a kidney disorder affecting children.
- Potential impacts of PNS on cardiac function, particularly the right ventricle (RV), are not fully understood.
Purpose of the Study:
- To evaluate right ventricle (RV) function and hemodynamics in children diagnosed with primary nephrotic syndrome (PNS).
Main Methods:
- Doppler echocardiography was used to assess RV hemodynamics in 50 children with PNS and 50 controls.
- Parameters included heart rate, stroke volume, cardiac output, RV volumes, ejection fraction, and pressures.
- Plasma levels of tumor necrosis factor-alpha (TNF-alpha) and insulin-like growth factor 1 (IGF-1) were measured.
Main Results:
- Children with PNS exhibited a 20% increase in RV end-diastolic pressure and a 15% reduction in RV ejection fraction compared to controls.
- Cardiac output and stroke volume were maintained through increased RV volumes and filling pressures.
- Elevated plasma TNF-alpha levels were observed in PNS patients, while IGF-1 levels were similar to controls.
Conclusions:
- Right ventricle function is impaired in children with PNS, characterized by altered pressures and volumes.
- These functional changes appear unrelated to blood pressure and IGF-1 but may be associated with TNF-alpha and disease duration.
- Further research is required to elucidate the causes and clinical significance of RV dysfunction in PNS.
Background:
We aimed to evaluate right ventricle (RV) function in children with primary nephrotic syndrome (PNS).
Methods:
RV hemodynamics were evaluated by Doppler echocardiography in 50 children with PNS (aged 2.5-12 years), either at PNS onset (n = 37) or relapse (n = 13), and in 50 normal controls. Heart rate, stroke volume, cardiac output, RV enddiastolic and end-systolic volume, RV ejection fraction, RV end-diastolic pressure, RV peak systolic and end-systolic pressure were determined from pressure-volume loops. The maximal rates of RV pressure upstroke and fall (dP/d t(max) and dP/d t(min), respectively) were calculated. Effective pulmonary arterial elastance was calculated as end-systolic pressure divided by stroke volume. Plasma tumor necrosis factor-alpha (TNF-alpha) and insulin-like growth factor 1 (IGF-1) were also measured.
Results:
RV end-diastolic pressure was increased by an average of 20% in 39 of the patients with PNS, whereas RV ejection fraction was reduced by an average of 15% compared with controls (p < 0.05 for both). Cardiac output and stroke volume were maintained, indicating compensation at the expense of increased RV end-diastolic and end-systolic volumes and increased RV filling pressure (p < 0.05). Plasma TNF-alpha was elevated in patients with PNS (326 +/- 117 kU/L vs. 75 +/- 23 kU/L, p < 0.05); IGF-1 was similar in PNS patients and controls.
Conclusion:
Right ventricle function was impaired in children with PNS. The characteristics were unrelated to blood pressure and IGF-1, but may be correlated with TNF-alpha and disease duration. Further studies are needed to evaluate the etiology and clinical implications of this abnormality.
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