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Speckle-Tracking Echocardiographic Measures of Right Ventricular Diastolic Function Correlate with Reference Standard Measures Before and After Preload Alteration in Children

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Abstract

The accuracy of echocardiographic measures of right ventricular (RV) diastolic function has been sparsely studied. Our objective was to evaluate the correlation between echocardiographic and reference standard measures of RV diastolic function derived from micromanometer pressure analysis before and after preload alteration in children. Echocardiograms and micromanometer pressure analyses were prospectively performed before and after fluid bolus in children undergoing right heart catheterization. The isovolumic relaxation time constant (τ) and end-diastolic pressure (EDP) were measured. Conventional and speckle-tracking echocardiographic (STE) parameters of RV systolic and diastolic function were assessed. Normal saline bolus was given to increase RV EDP by 20 %. Twenty-eight studies were performed in 22 patients with congenital heart disease or postheart transplantation. Mean age was 8.7 ± 6.1 years. RV longitudinal early diastolic strain rate (EDSR) correlated with τ before (r = 0.57, p = 0.001) and after fluid bolus (r = 0.48, p = 0.008). No conventional echocardiographic measures correlated with τ both before and after fluid bolus. Multiple regression analysis revealed RV EDSR and LV circumferential EDSR as independent predictors of RV τ. There were no independent predictors of EDP. RV EDSR appears to correlate with the reference standard measure of early active ventricular relaxation in children at baseline and after changes in preload. Conventional echocardiographic measures of diastolic function were not predictive of diastolic function after preload alteration. Future studies should assess the prognostic significance of STE measures of diastolic function in this population.

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Acknowledgments

Drs. Chowdhury and Goudar were funded by NIH/NHLBI Grant T32 HL07710.

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Authors and Affiliations

  1. Department of Pediatrics, Medical University of South Carolina, 165 Ashley Ave, MSC 915, Charleston, SC, 29425, USA

    Shahryar M. Chowdhury, G. Hamilton Baker, Carolyn L. Taylor & Karen S. Chessa

  2. The Ward Family Heart Center, Children’s Mercy Hospital, Kansas City, MO, USA

    Suma P. Goudar & Girish S. Shirali

  3. Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada

    Mark K. Friedberg, Andreea Dragulescu & Luc Mertens

Authors
  1. Shahryar M. Chowdhury
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  2. Suma P. Goudar
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  3. G. Hamilton Baker
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  5. Girish S. Shirali
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  7. Andreea Dragulescu
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  8. Karen S. Chessa
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  9. Luc Mertens
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Correspondence to Shahryar M. Chowdhury.

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Shahryar M. Chowdhury and Suma P. Goudar are joint first authors of this work.

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Chowdhury, S.M., Goudar, S.P., Baker, G.H. et al. Speckle-Tracking Echocardiographic Measures of Right Ventricular Diastolic Function Correlate with Reference Standard Measures Before and After Preload Alteration in Children. Pediatr Cardiol 38, 27–35 (2017). https://doi.org/10.1007/s00246-016-1479-3

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  • DOI: https://doi.org/10.1007/s00246-016-1479-3

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