Martin Koestenberger1,2, Alexander Avian3, Phillippe Chouvarine4,5, Andreas Gamillscheg6,4, Gerhard Cvirn7, Sabrina Schweintzger6,4, Stefan Kurath-Koller6,4, Massimiliano Cantinotti4,8, Dagmar Hohmann5, Georg Hansmann9,10. 1. Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria. martin.koestenberger@medunigraz.at. 2. European Pediatric Pulmonary Vascular Disease Network, Berlin, Germany. martin.koestenberger@medunigraz.at. 3. Institute for Medical Informatics, Statistics and Documentation, Medical University Graz, Graz, Austria. 4. European Pediatric Pulmonary Vascular Disease Network, Berlin, Germany. 5. Department of Pediatric Cardiology and Critical Care, Hannover Medical School, Hannover, Germany. 6. Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria. 7. Centre of Physiological Medicine, Medical University Graz, Graz, Austria. 8. Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Pisa, Italy. 9. European Pediatric Pulmonary Vascular Disease Network, Berlin, Germany. georg.hansmann@gmail.com. 10. Department of Pediatric Cardiology and Critical Care, Hannover Medical School, Hannover, Germany. georg.hansmann@gmail.com.
Abstract
BACKGROUND: Echocardiographic determination of the right ventricular end-systolic remodeling index (RVES RI) has clinical value for the assessment of pulmonary hypertension (PH) in adults. We aim to determine RVES RI values in pediatric PH and to correlate RVES RI data with echocardiographic variables and NYHA functional class (FC). METHODS: Prospective echocardiography study in 49 children with PH. The 49 matched control subjects were chosen from 123 healthy children used to construct pediatric normal reference values. The associations with invasive hemodynamic variables were also investigated in a validation cohort of 12 PH children and matched controls. RESULTS: RVES RI was increased in children with PH vs. healthy controls (1.45 ± 0.16 vs. 1.16 ± 0.06; p < 0.01; confirmed in the validation cohort). RVES RI was associated with invasive hemodynamic variables, i.e. the mean pulmonary artery pressure. RVES RI values increased with worsening NYHA-FC. The highest RVES RI values were observed in PH children with NYHA FC 3 (1.60 ± 0.12). CONCLUSIONS: RVES RI is a useful indicator of RV remodeling and dilation in the setting of increased RV pressure load, especially when the degree of regurgitation of the tricuspid and pulmonary valves is insufficient to numerically estimate RV systolic pressure and mPAP, due to incomplete Doppler envelopes.
BACKGROUND: Echocardiographic determination of the right ventricular end-systolic remodeling index (RVES RI) has clinical value for the assessment of pulmonary hypertension (PH) in adults. We aim to determine RVES RI values in pediatric PH and to correlate RVES RI data with echocardiographic variables and NYHA functional class (FC). METHODS: Prospective echocardiography study in 49 children with PH. The 49 matched control subjects were chosen from 123 healthy children used to construct pediatric normal reference values. The associations with invasive hemodynamic variables were also investigated in a validation cohort of 12 PHchildren and matched controls. RESULTS: RVES RI was increased in children with PH vs. healthy controls (1.45 ± 0.16 vs. 1.16 ± 0.06; p < 0.01; confirmed in the validation cohort). RVES RI was associated with invasive hemodynamic variables, i.e. the mean pulmonary artery pressure. RVES RI values increased with worsening NYHA-FC. The highest RVES RI values were observed in PHchildren with NYHA FC 3 (1.60 ± 0.12). CONCLUSIONS: RVES RI is a useful indicator of RV remodeling and dilation in the setting of increased RV pressure load, especially when the degree of regurgitation of the tricuspid and pulmonary valves is insufficient to numerically estimate RV systolic pressure and mPAP, due to incomplete Doppler envelopes.
Authors: Martin Koestenberger; Georg Hansmann; Christian Apitz; Heiner Latus; Astrid Lammers Journal: Paediatr Respir Rev Date: 2016-10-26 Impact factor: 2.726
Authors: Sabrina Schweintzger; Stefan Kurath-Koller; Ante Burmas; Gernot Grangl; Andrea Fandl; Nathalie Noessler; Alexander Avian; Andreas Gamillscheg; Philippe Chouvarine; Georg Hansmann; Martin Koestenberger Journal: Front Cardiovasc Med Date: 2022-07-14
Authors: Maurice Beghetti; Rolf M F Berger; Damien Bonnet; Simon Grill; Catherine Lesage; Jean-Christophe Lemarie; D Dunbar Ivy Journal: Front Pediatr Date: 2021-06-16 Impact factor: 3.418