Intraventricular pressure difference estimation based on blood speckle tracking-invasive validation and early...

Area of Science:

• Cardiology
• Medical Imaging
• Pediatric Cardiology

Background:

• Ventricular relaxation generates intraventricular pressure difference (IVPD), crucial for diastolic suction and overall diastolic function.
• Non-invasive echocardiographic techniques are needed for clinical evaluation of IVPD.

Purpose of the Study:

• To validate Blood Speckle Tracking (BST) echocardiography for IVPD estimation against invasive measurements.
• To assess the clinical applicability of BST-based IVPD in children with univentricular hearts (UVH) and healthy controls.

Main Methods:

• Validation in an open-chest porcine model comparing BST-derived IVPD with invasive micromanometer catheter measurements.
• Clinical application in 83 healthy children and 44 children with UVH, assessing feasibility and IVPD during early diastole.

Main Results:

• High correlation (r=0.95) and minimal difference (-0.01 mmHg) between BST-IVPD and invasive measurements in pigs.
• Feasibility of BST-IVPD was high (93.9% controls, 88.6% UVH).
• Median IVPD was significantly lower in UVH patients (-0.88 mmHg) compared to controls (-1.82 mmHg), indicating reduced diastolic suction.

Conclusions:

• BST echocardiography accurately estimates IVPD in early diastole.
• Children with UVH exhibit significantly lower IVPD, suggesting impaired diastolic suction and potential impact on cardiac filling.