We have located links that may give you full text access.
Comparative Study
Journal Article
Evaluation of ventricular filling pressures and ventricular function by Doppler echocardiography in patients with functional single ventricle: correlation with simultaneous cardiac catheterization.
Journal of the American Society of Echocardiography 2011 November
BACKGROUND: Elevated ventricular filling pressure is a marker of diastolic dysfunction and a known risk factor for failure of single-ventricle surgical palliation. Doppler echocardiography has been shown valuable in identifying patients with elevated ventricular end-diastolic pressure (VEDP) in other settings, but its utility in evaluating pediatric patients with single ventricle is unclear. The aim of this study was to compare Doppler parameters to simultaneous catheter measurements of VEDP in children with single ventricle.
METHODS: All consecutive patients (age < 18 years) with single ventricle who underwent simultaneous echocardiography and catheterization in 2009 and 2010 were included in this prospective study. Data regarding diagnosis, morphology of the "single" ventricle, prior surgeries, Doppler tissue imaging (DTI), atrioventricular valve inflow and pulmonary vein Doppler, and myocardial performance index (MPI) were collected. Ventricular Doppler echocardiography was performed from the dominant ventricle. Simultaneous Doppler and catheter measurements of systolic and diastolic function and VEDP were obtained. Correlation of continuous variables was examined using linear regression analysis. Receiver operating characteristic curves, two-sample Student's t tests, χ(2) analyses, and Fisher's exact tests were used as appropriate.
RESULTS: A total of 32 patients (15 male; mean age, 30.2 ± 22 months) were studied (nine post-Fontan, 15 post-Glenn, and eight pre-Glenn). Mean systemic arterial saturation was 81 ± 10%, mean VEDP was 11 ± 3 mm Hg, and mean echocardiographically estimated ejection fraction was 55 ± 7%. VEDP was correlated positively with E/E' ratio (r = 0.44, P < .01), pulmonary vein atrial reversal duration (r = 0.77, P < .001), and E' (r = 0.49, P < .01). Receiver operating characteristic curve analysis using an E/E' cutoff of 12 showed sensitivity of 90% (95% confidence interval, 54.1%-99.5%) and specificity of 75.0% (95% confidence interval, 47.4%-91.7%) for identifying VEDP > 10 mm Hg. Single left ventricles had higher DTI S' and E' velocities and lower E/E' ratios and MPIs compared with single right ventricles. S' velocity correlated positively with ejection fraction (r = 0.77, P < .001) and negatively with single left ventricular MPI (r = -0.46, P < .01).
CONCLUSIONS: In patients with single-ventricle physiology, DTI and pulmonary vein Doppler echocardiographic parameters correlated modestly with direct measurement of VEDP and may be helpful in identifying patients with elevated filling pressures. In addition, single left ventricles had better systolic and diastolic performance than single right ventricles. DTI systolic velocities and left ventricular MPI correlated well with ventricular ejection fraction.
METHODS: All consecutive patients (age < 18 years) with single ventricle who underwent simultaneous echocardiography and catheterization in 2009 and 2010 were included in this prospective study. Data regarding diagnosis, morphology of the "single" ventricle, prior surgeries, Doppler tissue imaging (DTI), atrioventricular valve inflow and pulmonary vein Doppler, and myocardial performance index (MPI) were collected. Ventricular Doppler echocardiography was performed from the dominant ventricle. Simultaneous Doppler and catheter measurements of systolic and diastolic function and VEDP were obtained. Correlation of continuous variables was examined using linear regression analysis. Receiver operating characteristic curves, two-sample Student's t tests, χ(2) analyses, and Fisher's exact tests were used as appropriate.
RESULTS: A total of 32 patients (15 male; mean age, 30.2 ± 22 months) were studied (nine post-Fontan, 15 post-Glenn, and eight pre-Glenn). Mean systemic arterial saturation was 81 ± 10%, mean VEDP was 11 ± 3 mm Hg, and mean echocardiographically estimated ejection fraction was 55 ± 7%. VEDP was correlated positively with E/E' ratio (r = 0.44, P < .01), pulmonary vein atrial reversal duration (r = 0.77, P < .001), and E' (r = 0.49, P < .01). Receiver operating characteristic curve analysis using an E/E' cutoff of 12 showed sensitivity of 90% (95% confidence interval, 54.1%-99.5%) and specificity of 75.0% (95% confidence interval, 47.4%-91.7%) for identifying VEDP > 10 mm Hg. Single left ventricles had higher DTI S' and E' velocities and lower E/E' ratios and MPIs compared with single right ventricles. S' velocity correlated positively with ejection fraction (r = 0.77, P < .001) and negatively with single left ventricular MPI (r = -0.46, P < .01).
CONCLUSIONS: In patients with single-ventricle physiology, DTI and pulmonary vein Doppler echocardiographic parameters correlated modestly with direct measurement of VEDP and may be helpful in identifying patients with elevated filling pressures. In addition, single left ventricles had better systolic and diastolic performance than single right ventricles. DTI systolic velocities and left ventricular MPI correlated well with ventricular ejection fraction.
Full text links
Related Resources
Trending Papers
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Prevention and treatment of ischaemic and haemorrhagic stroke in people with diabetes mellitus: a focus on glucose control and comorbidities.Diabetologia 2024 April 17
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Eosinophilic Esophagitis: Clinical Pearls for Primary Care Providers and Gastroenterologists.Mayo Clinic Proceedings 2024 April
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app