BACKGROUND: In infants with pulmonary hypertension (PHT), right ventricular (RV) function may be altered and contribute to disease severity. Tissue Doppler imaging (TDI) is a new echocardiographic modality which directly measures myocardial velocities and may allow quantitative assessment of systolic and diastolic ventricular function in infants. OBJECTIVE: To measure and compare RV myocardial velocities in infants with PHT and in normal control infants, using TDI. METHODS: This was a prospective case-control study. Twenty-eight control infants and 15 infants with PHT, of whom 11 had congenital diaphragmatic hernia (CDH), were recruited. TDI was used to obtain systolic and diastolic myocardial velocities in the RV and interventricular septum in all infants. RESULTS: There were significant reductions in systolic isovolumic contraction velocity (IVV; 5.3 vs. 6.6 cm/s) and systolic ejection velocity (S; 6.6 vs. 9.2 cm/s) in the PHT group compared to the control group. Early diastolic myocardial velocity, E', was also significantly reduced in the RV in the PHT infants compared to controls (-4.3 vs. 8.6 cm/s). The same significant reductions in systolic and early diastolic TDI velocities were observed in the subgroup of CDH infants alone. CONCLUSIONS: TDI permits non-invasive assessment of RV myocardial velocities in infants. Reduced systolic and diastolic velocities in PHT may represent impaired systolic contraction and early diastolic relaxation. Therapies which target inotropic and lusitropic function may be appropriate in infants with PHT and RV dysfunction. The load-dependency of TDI measures in infants and the effects of specific therapies on RV function in PHT require further investigation. Copyright 2009 S. Karger AG, Basel.
BACKGROUND: In infants with pulmonary hypertension (PHT), right ventricular (RV) function may be altered and contribute to disease severity. Tissue Doppler imaging (TDI) is a new echocardiographic modality which directly measures myocardial velocities and may allow quantitative assessment of systolic and diastolic ventricular function in infants. OBJECTIVE: To measure and compare RV myocardial velocities in infants with PHT and in normal control infants, using TDI. METHODS: This was a prospective case-control study. Twenty-eight control infants and 15 infants with PHT, of whom 11 had congenital diaphragmatic hernia (CDH), were recruited. TDI was used to obtain systolic and diastolic myocardial velocities in the RV and interventricular septum in all infants. RESULTS: There were significant reductions in systolic isovolumic contraction velocity (IVV; 5.3 vs. 6.6 cm/s) and systolic ejection velocity (S; 6.6 vs. 9.2 cm/s) in the PHT group compared to the control group. Early diastolic myocardial velocity, E', was also significantly reduced in the RV in the PHT infants compared to controls (-4.3 vs. 8.6 cm/s). The same significant reductions in systolic and early diastolic TDI velocities were observed in the subgroup of CDH infants alone. CONCLUSIONS:TDI permits non-invasive assessment of RV myocardial velocities in infants. Reduced systolic and diastolic velocities in PHT may represent impaired systolic contraction and early diastolic relaxation. Therapies which target inotropic and lusitropic function may be appropriate in infants with PHT and RV dysfunction. The load-dependency of TDI measures in infants and the effects of specific therapies on RV function in PHT require further investigation. Copyright 2009 S. Karger AG, Basel.
Authors: Philip Thaler Levy; Mark R Holland; Timothy J Sekarski; Aaron Hamvas; Gautam K Singh Journal: J Am Soc Echocardiogr Date: 2013-07-20 Impact factor: 5.251
Authors: M N Trottier-Boucher; A Lapointe; J Malo; A Fournier; M J Raboisson; B Martin; A Moussa Journal: Pediatr Cardiol Date: 2015-04-01 Impact factor: 1.655
Authors: Philip T Levy; Aura A Sanchez Mejia; Aliza Machefsky; Susan Fowler; Mark R Holland; Gautam K Singh Journal: J Am Soc Echocardiogr Date: 2014-02-26 Impact factor: 5.251
Authors: Matthew J Egan; Nazia Husain; Jack R Stines; Nasser Moiduddin; Melanie A Stein; Leif D Nelin; Clifford L Cua Journal: World J Pediatr Date: 2012-11-15 Impact factor: 2.764