Related Experiment Video
Updated: Feb 16, 2026
Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice
Published on: February 14, 2017
Echocardiographic Detection of Increased Ventricular Diastolic Stiffness in Pediatric Heart Transplant Recipients: A
Shahryar M Chowdhury1, Ryan J Butts2, Anthony M Hlavacek1
1Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina.
Insights
Novel echocardiographic measures accurately assess left ventricular (LV) diastolic stiffness in pediatric heart transplant recipients. These noninvasive methods show promise for evaluating LV stiffness in children post-transplant.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Medical Imaging
Background:
- Pediatric heart transplant recipients face risks of increased left ventricular (LV) diastolic stiffness.
- Noninvasive evaluation of LV stiffness in this population has been challenging.
Purpose of the Study:
- To compare novel echocardiographic measures of LV diastolic stiffness with gold-standard pressure-volume loop (PVL) analysis.
- To assess the accuracy of echocardiography in pediatric heart transplant recipients.
Main Methods:
- Prospective enrollment of patients undergoing left heart catheterization.
- Acquisition of PVLs and calculation of stiffness constant (β) via balloon occlusion.
- Derivation of echocardiographic measures including E:e'/end-diastolic volume (EDV) and E:early diastolic strain rate/EDV using Doppler and speckle-tracking.
Main Results:
- Echocardiographic measures like lateral E:e'/EDV, septal E:e'/EDV, and E:circumferential early diastolic strain rate/EDV correlated significantly with β.
- Lateral E:e'/EDV demonstrated high accuracy (C statistic of 0.93) in detecting abnormal LV stiffness.
- A threshold of lateral E:e'/EDV >0.15 mL⁻¹ showed 89% sensitivity and 93% specificity for abnormal β.
Conclusions:
- Echocardiographic estimates of ventricular stiffness show potential accuracy compared to gold-standard PVL analysis in pediatric heart transplant recipients.
- Further research is warranted to explore the clinical utility of these noninvasive measures for assessing LV stiffness in children.
Background:
Pediatric heart transplant recipients are at risk for increased left ventricular (LV) diastolic stiffness. However, the noninvasive evaluation of LV stiffness has remained elusive in this population. The objective of this study was to compare novel echocardiographic measures of LV diastolic stiffness versus gold-standard measures derived from pressure-volume loop (PVL) analysis in pediatric heart transplant recipients.
Methods:
Patients undergoing left heart catheterization were prospectively enrolled. PVLs were obtained via conductance. The end-diastolic pressure-volume relationship was obtained via balloon occlusion. The stiffness constant, β, was calculated. Echocardiographic measures of diastolic function were derived from spectral and tissue Doppler and two-dimensional speckle-tracking. Ventricular volumes were measured using three-dimensional echocardiography. The novel echocardiographic estimates of ventricular stiffness included E:e'/end-diastolic volume (EDV) and E:early diastolic strain rate/EDV.
Results:
Of 24 children, 18 were heart transplant recipients. Six control patients had hemodynamically insignificant patent ductus arteriosus or coronary fistula. The mean age was 9.1 ± 5.6 years. Median end-diastolic pressure was 9 mm Hg (interquartile range, 8-13 mm Hg). Lateral E:e'/EDV (r = 0.59, P < .01), septal E:e'/EDV (r = 0.57, P < .01), and (E:circumferential early diastolic strain rate)/EDV (r = 0.54, P < .01) correlated with β. Lateral E:e'/EDV displayed a C statistic of 0.93 in detecting patients with abnormal LV stiffness (β > 0.015 mL-1). A lateral E:e'/EDV of >0.15 mL-1 had 89% sensitivity and 93% specificity in detecting an abnormal β.
Conclusions:
Echocardiographic estimates of ventricular stiffness may be accurate compared with the gold standard in pediatric heart transplant recipients. The clinical usefulness of these noninvasive measures in assessing LV stiffness merits further study in children.
More Related Videos
04:48Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
11:50High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart
Published on: July 9, 2010
