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Assessment of the pulmonary vascular bed by echocardiographic right ventricular systolic time intervals
Insights
This study found that the ratio of right ventricular pre-ejection period to ejection time (RPEP/RVET) effectively predicts pulmonary artery diastolic pressure in children. This non-invasive echocardiographic method shows high accuracy, aiding in diagnosing pulmonary hypertension.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Pulmonary Hypertension
Background:
- Right ventricular systolic time intervals (RVSTI) are echocardiographic measures.
- Assessing pulmonary artery (PA) pressures non-invasively is crucial in pediatric cardiology.
Purpose of the Study:
- To evaluate the correlation between RVSTI and PA pressures.
- To determine if RPEP/RVET can predict PA diastolic pressure in children.
Main Methods:
- Echocardiography was used to measure RVSTI in 85 normal children and 229 patients.
- Right ventricular pre-ejection period (RPEP) and right ventricular ejection time (RVET) were corrected.
- RPEP/RVET was correlated with PA diastolic pressure, mean PA pressure, and pulmonary vascular resistance (PVR).
Main Results:
- A strong correlation (0.83) was found between RPEP/RVET and PA diastolic pressure.
- RPEP/RVET predicted PA diastolic pressure within 10 mm Hg in 85% of patients.
- Changes in RPEP/RVET accurately reflected changes in PA diastolic pressure in sequential data.
Conclusions:
- RPEP/RVET is a valuable non-invasive tool for predicting PA diastolic pressure in children.
- This method is limited in patients with congestive cardiomyopathy or complete right bundle branch block.
- Echocardiographic RVSTI offers a promising approach for monitoring pulmonary hemodynamics.
Abstract:
Echocardiography was used to measure right ventricular systolic time intervals (RVSTI) in 85 normal children (group I) and in 229 patients undergoing cardiac catheterization (group II). Corrected right ventricular pre-ejection period (RPEPC) and right ventricular ejection time (RVETc) (based on regression analysis of group I) and RPEP/RVET were each correlated with pulmonary artery (PA) diastolic and mean pressures and pulmonary vascular resistance (PVR). The best correlation (0.83) was between a second degree polynomial of the RPEP/RVET and PA diastolic pressure. The RPEP/RVET allowed prediction of PA diastolic pressure within 10 mm Hg in 85% of the patients. The utility of RPEP/RVET was confirmed in sequential data of 22 patients, in whom alteration in RPEP/RVET accurately reflected the changing PA diastolic pressure. The RPEP/RVET could not be used to assess PA pressure in six patients with congestive cardiomyopathy nor in 18 patients with complete right bundle branch block (CRBBB).
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