Right Ventricular Diastolic Performance in Children With Pulmonary Arterial Hypertension Associated With Congenital Heart Disease Correlation of Echocardiographic Parameters With Invasive Reference Standards by High-Fidelity Micromanometer Catheter
Right Ventricular Diastolic Performance in Children With Pulmonary Arterial Hypertension Associated With Congenital Heart Disease Correlation of Echocardiographic Parameters With Invasive Reference Standards by High-Fidelity Micromanometer Catheter
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DOI：
10.1161/circimaging.113.001071
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发表时间：
2014-05-01
影响因子：
7.5
通讯作者：
Friedberg, Mark K.
中科院分区：
文献类型：
--
作者：
Okumura, Kenichi;Slorach, Cameron;Friedberg, Mark K.
背景-右心室舒张功能障碍影响肺动脉高压（PAH）的预后，但超声心动图参数与儿童PAH有创参考标准的关系尚未研究。我们调查了超声心动图参数的右心室舒张功能的儿童PAH的同时测量侵入性reference measurements.Methods和Results-We前瞻性招募儿童进行临床指征的心导管检查评估PAH和肺血管反应性试验。超声心动图与高保真微压计导管侵入性参考测量同时进行。为了进行分析，将患者分为分流组和非分流组。研究了16名儿童。在整个组中，tau蛋白与三尖瓣减速时间、E '、E/E'、时间（E-E '）、A波速度和整体舒张早期和晚期应变率之间存在显著相关性。dp/dt最小值与舒张晚期三尖瓣环速度（A '）、组织多普勒成像衍生的收缩期：舒张期持续时间比和整体舒张晚期应变率显著相关。舒张末期压与组织多普勒成像得出的收缩期：舒张期持续时间比显著相关。在多变量分析中，三尖瓣减速时间、时间（E-E '）和总体舒张早期应变率是tau的独立预测因子，而组织多普勒成像衍生的收缩期：舒张期持续时间比是dp/dt最小值的独立预测因子。在一般情况下，超声心动图和侵入性参数之间的相关性更好的分流组比在nonshunt group. Conclusions超声心动图相关的右心室舒张功能的儿童有创参考措施，PAH，虽然它不区分早期与晚期舒张异常。较新的超声心动图技术可能对评估这一人群的右心室舒张功能障碍具有附加价值。
Background-Right ventricular diastolic dysfunction influences outcomes in pulmonary arterial hypertension (PAH), but echocardiographic parameters have not been investigated in relation to invasive reference standards in pediatric PAH. We investigated echocardiographic parameters of right ventricular diastolic function in children with PAH in relation to simultaneously measured invasive reference measures.Methods and Results-We prospectively recruited children undergoing a clinically indicated cardiac catheterization for evaluation of PAH and pulmonary vasoreactivity testing. Echocardiography was performed simultaneously with invasive reference measurements by high-fidelity micromanometer catheter. For analysis, patients were divided into shunt and nonshunt groups. Sixteen children were studied. In the group as a whole, significant correlations were found among tau and tricuspid deceleration time, E', E/E', Time(E-E'), A wave velocity, and global early and late diastolic strain rate. dp/dt minimum correlated significantly with late diastolic tricuspid annular velocity (A'), tissue Doppler imaging-derived systolic: diastolic duration ratio, and global late diastolic strain rate. End-diastolic pressure correlated significantly with tissue Doppler imaging-derived systolic: diastolic duration ratio. On multivariate analysis, tricuspid deceleration time, Time(E-E'), and global early diastolic strain rate were independent predictors of tau, whereas tissue Doppler imaging-derived systolic: diastolic duration ratio was an independent predictor of dp/dt minimum. In general, correlations between echocardiographic and invasive parameters were better in the shunt group than in the nonshunt group.Conclusions-Echocardiography correlates with invasive reference measures of right ventricular diastolic function in children with PAH, although it does not differentiate between early versus late diastolic abnormalities. Newer echocardiographic techniques may have added value to assess right ventricular diastolic dysfunction in this population.