Assessment of left-ventricular diastolic function in pediatric intensive-care patients: a review of parameters and indications compared with those for adults
Related Experiment Video
Updated: Dec 19, 2025
Echocardiographic Assessment of Cardiac Anatomy and Function in Adult Rats
Published on: December 13, 2019
Morgan Recher1,2, Astrid Botte3, Jerome Soquet4
1ULR 2694 - METRICS : Évaluation des Technologies de santé et des Pratiques Médicales, Univ. Lille, CHU Lille, 59000, Lille, France. morgan.recher@chru-lille.fr.
Insights
Diastolic heart failure evaluation is complex in pediatric intensive care. Doppler echocardiography offers key criteria for assessing ventricular relaxation and compliance in critically ill children and adults.
Area of Science:
- Cardiology
- Pediatric Critical Care
- Echocardiography
Background:
- Diastolic heart failure incidence is rising.
- Evaluating left-ventricular diastolic function is challenging, especially in pediatric intensive care.
- This review updates the assessment of diastolic function in adult and pediatric intensive care settings.
Purpose of the Study:
- To review the literature on evaluating left-ventricular diastolic function in intensive care.
- To provide an update on diastolic function assessment in adults and children.
- To address key questions regarding the pathophysiology, tools, echocardiographic criteria, and timing of diastolic function evaluation in pediatric intensive care.
Main Methods:
- Literature search of PubMed/Medline.
- Inclusion of 32 studies.
- Focused on four pragmatic questions regarding diastolic dysfunction.
Main Results:
- Diastolic function assessment involves early (relaxation) and late (compliance, filling pressures) phases.
- Differences exist in diastolic function evolution between adults and children; children exhibit simultaneous decreased compliance and delayed relaxation.
- Doppler echocardiography provides criteria for relaxation (E wave, E/A ratio, isovolumic relaxation time) and compliance (E/e' ratio, atrial volume, Ap wave duration).
Conclusions:
- The E/e' ratio aids in managing fluid tolerance and inotropic support in adult septic patients.
- Further clinical studies are needed to validate diastolic function parameters for pediatric intensive care use.
Background:
The incidence of diastolic heart failure has increased over time. The evaluation of left-ventricular diastolic function is complex, ongoing, and remains poorly performed in pediatric intensive-care patients. This study aimed to review the literature and to provide an update on the evaluation of left-ventricular diastolic function in adults and children in intensive care.
Data Sources:
We searched data from PubMed/Medline. Thirty-two studies were included. Four pragmatic questions were identified: (1) What is the physiopathology of diastolic dysfunction? (2) Which tools are required to evaluate diastolic function? (3) What are the echocardiographic criteria needed to evaluate diastolic function? (4) When should diastolic function be evaluated in pediatric intensive care?
Results:
Early diastole allows characterization of relaxation, whereas compliance assessments and filling pressures are evaluated during late diastole. The evolution of diastolic function differs between adults and children. Unlike in adults, decreased compliance occurs at the same time as delayed relaxation in children. Diastolic function can be evaluated by Doppler echocardiography. The echocardiographic criteria for ventricular relaxation include the E wave, E/A wave ratio, and isovolumic relaxation time. Ventricular compliance can be assessed by the E/e' wave ratio, atrial volume, and Ap wave duration during pulmonary vein flow. In adult intensive-care patients, the E/e' ratio can be used as an index of tolerance for volume expansion in septic patients and to adjust the inotropic support.
Conclusion:
Clinical studies would allow some of these parameters to be validated for use in children in intensive care.
More Related Videos
09:31Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
12:12Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice
Published on: February 14, 2017