[Doppler echocardiographic evaluation of left ventricular configuration and function in children with pulmonary artery hypertension secondary to congenital heart disease].

OBJECTIVE: To evaluate the value of Doppler echocardiography in the diagnosis of pulmonary artery hypertension (PAH) and the effect of PAH on left ventricular remodelling and diastolic function using Doppler echocardiography in children with congenital heart disease (CHD).

METHODS: Doppler echocardiography was performed on 45 CHD children with PAH (PAH group) and the results were compared with those of 22 CHD children with normal pulmonary artery pressure (control group).

RESULTS: Doppler echocardiography showed that the diameter of end-diastolic left ventricular (18.24 +/-1.71 mm vs 16.28 +/-0.52 mm), the diameter of right ventricular (12.23 +/-2.14 mm vs 8.14 +/-0.73 mm), and the pulmonary artery diameter (11.20 +/-1.35 mm vs 7.92 +/-0.21 mm ) increased significantly in the PAH group compared with those in the control group (P < 0.05). The PAH group had higher velocity of tricuspid valve regurgitation (2.56 +/-0.46 m/s) and higher pulmonary artery pressure (40.23 +/-4.56 mmHg) than the control group (P < 0.05). The PAH group had also higher mitral peak A velocity (AV, 94.56 +/-31.45 m/s vs 51.17 +/-26.67 m/s), higher mitral AV velocity-time intergrate (10.89 +/-2.73 s vs 4.94 +/-1.85 s), higher ratio of mitral AV to mitral peak E velocity (EV) (1.79 +/-0.32 vs 0.59+/-0.19 and higher ratio of mitral velocity-time intergrate of AV/EV (1.61+/-0.49 vs 0.45 +/-0.21) than the control group. The left ventricular isovolumetric relaxation time (119.86 +/-54.62 s vs 52.31 +/-28.06 s) was prolonged in the PAH group (P < 0.05). In the PAH group, there was a positive correlation between the increased pulmonary artery pressure and the ratio of mitral AV/EV (r=0.4456, P < 0.01).

CONCLUSIONS: Doppler echocardiography is not only an important non-invasive diagnostic technique for PAH in children with CHD, but also a tool which can indicate the left ventricular remodelling and diastolic dysfunction induced by PAH. It is useful to evaluate the severity and the prognosis of PAH secondary to CHD.