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Published on: November 28, 2018
The evaluation of diastolic function using the diastolic wall strain (DWS) before and after radical surgery for
Tomohiko Tanaka1, Noboru Inamura2, Ryo Ishii2
1Department of Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan. ttanaka@mch.pref.osaka.jp.
Insights
Diastolic wall strain (DWS) effectively measures cardiac diastolic function in congenital diaphragmatic hernia (CDH) patients. This new method showed significant improvement in DWS after surgery, indicating its utility in CDH cardiac assessment.
Area of Science:
- Cardiology
- Pediatric Surgery
- Medical Imaging
Background:
- Congenital diaphragmatic hernia (CDH) poses significant risks to neonatal cardiac function.
- Evaluating diastolic function in CDH patients is crucial for management and prognosis.
- Traditional methods may not fully capture the nuances of diastolic dysfunction in this population.
Purpose of the Study:
- To evaluate ventricular diastolic function in neonates with CDH using diastolic wall strain (DWS).
- To assess the changes in cardiac function, including DWS, before and after surgical repair of CDH.
- To determine the efficacy of DWS as a novel method for assessing diastolic function in CDH.
Main Methods:
- Studied 18 neonates with CDH, measuring left ventricular posterior wall thickness via M-mode imaging.
- Calculated DWS using the formula (PWs-PWd)/PWs.
- Assessed other cardiac function indices like Tei index, isovolumic relaxation time (IRT), and fraction shortening (FS) pre- and post-surgery.
Main Results:
- DWS improved significantly after surgery (0.19 ± 0.06 pre-op vs. 0.26 ± 0.11 post-op, P < 0.01).
- Other cardiac function indices also showed significant changes: Tei index (P < 0.05), IRT (P < 0.05), and FS (P < 0.05).
- These findings suggest a measurable improvement in cardiac function post-CDH repair.
Conclusions:
- Diastolic wall strain (DWS) is a valuable tool for assessing diastolic function in CDH patients.
- DWS, alongside Tei index, IRT, and FS, provides a comprehensive evaluation of cardiac function.
- The improvement in DWS post-surgery highlights its clinical relevance in managing CDH patients.
Objective:
The measurement of diastolic wall strain (DWS), a new method of evaluating cardiac diastolic function, was employed to evaluate ventricular diastolic function in patients with congenital diaphragmatic hernia (CDH).
Materials And Methods:
Eighteen neonates with a CDH who were born and treated in our hospital between September 2009 and January 2013 were studied. The left ventricular posterior wall thickness during the systolic phase (PWs) and diastolic (PWd) phase was measured using M-mode imaging, and the DWS was calculated as (PWs-PWd)/PWs. The Tei index, the isovolumic relaxation time (IRT), and the fraction shortening (FS) were measured as indices of cardiac function in 14, 15, and 18 cases, respectively. Cardiac function was measured before and after surgery. Statistical analyses were performed using the paired t test.
Results:
The pre- and postoperative DWS, Tei index, IRT and FS values were 0.19 ± 0.06 and 0.26 ± 0.11 (P < 0.01), 0.40 ± 0.12 and 0.31 ± 0.11 (P < 0.05), 48 ± 14 and 39 ± 5.0 ms (P < 0.05), 30 ± 7.7 and 34 ± 7.4 % (P < 0.05), respectively.
Conclusion:
The diastolic and systolic functions were not only measured by the Tei index, IRT and FS values, but also by the DWS value, which improved after surgery. The measurement of DWS is an easy and useful method for evaluating the diastolic function of CDH patients.
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