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Myocardial Tissue Doppler Velocity in Child Growth
Sun-Ha Choi1, Lucy Youngmin Eun1, Nam Kyun Kim1
1Division of Pediatric Cardiology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
Insights
Myocardial tissue Doppler imaging (TDI) velocities in children are influenced by cardiac growth. Diastolic function positively correlates with cardiac growth, impacting assessments in both healthy and sick children.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Cardiac Physiology
Background:
- Tissue Doppler imaging (TDI) is standard for adult echocardiography but less accepted in children due to variability.
- Pediatric TDI velocities exhibit significant age-dependent variations.
- Understanding these variations is crucial for accurate pediatric cardiac assessment.
Purpose of the Study:
- To examine myocardial tissue Doppler velocity distribution in healthy children.
- To assess the impact of age and cardiac growth on echocardiographic measurements.
- To establish normative data for pediatric TDI.
Main Methods:
- 144 healthy children were enrolled from a pediatric outpatient clinic.
- Statistical analyses explored relationships between age, body surface area (BSA), left ventricle end-diastolic dimension (LVEDD), and TDI values.
- Multivariate analysis assessed cardiac growth parameters (age, BSA, LVEDD) and TDI velocity data.
Main Results:
- Age, BSA, and LVEDD positively correlated with deceleration time (DT), pressure half-time (PHT), peak early diastolic, and peak systolic myocardial velocities.
- These parameters negatively correlated with peak late diastolic velocity (A) and E/E' ratio.
- Multivariate analysis confirmed these correlations, highlighting cardiac growth's influence.
Conclusions:
- Diastolic myocardial velocities are cardiac growth dependent in children.
- Diastolic function shows a positive correlation with cardiac growth in the pediatric population.
- These findings are vital for assessing cardiac involvement in pediatric patients.
Background:
In adults, tissue Doppler imaging (TDI) is a recommended component of routine echocardiography. However, TDI velocities are less accepted in pediatrics, due to their strong variability and age dependence in children. This study examines the distribution of myocardial tissue Doppler velocities in healthy children to assess the effect of age with cardiac growth on the various echocardiographic measurements.
Methods:
Total 144 healthy children were enrolled in this study. They were recruited from the pediatric outpatient clinic for routine well-child visits. The statistical relationships between age and TDI values were analyzed. Also, the statistical relationships between body surface area (BSA) and TDI values, left ventricle end-diastolic dimension (LVEDD) and TDI values were analyzed. Also, we conducted multivariate analysis of cardiac growth parameters such as, age, BSA, LVEDD and TDI velocity data.
Results:
All of the age, BSA, and LVEDD had positive correlations with deceleration time (DT), pressure half-time (PHT), peak early diastolic myocardial velocity, peak systolic myocardial velocity, and had negative correlations with peak late diastolic velocity (A) and the ratio of trans-mitral inflow velocity to early diastolic velocity of mitral annulus (E/E'). In the multivariate analysis, all of the age, BSA, and LVEDD had positive correlations with DT, PHT, and negative correlations with A and E/E'.
Conclusion:
The cardiac growth parameters related alterations of E/E' may suggest that diastolic myocardial velocities are cardiac growth dependent, and diastolic function has positive correlation with cardiac growth in pediatric group. This cardiac growth related myocardial functional variation would be important for assessment of cardiac involvement either in healthy and sick child.
