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Doppler myocardial performance index in assessment of ventricular function in children with single ventricles

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Abstract

Background

Quantitative assessment of ventricular function in children with single ventricles is both difficult and subjective because of asymmetric ventricular geometry. The Doppler myocardial performance index (MPI) allows the assessment regardless of ventricular shape. This study was designed to evaluate the feasibility of MPI in assessing ventricular function in children with single ventricles before and after total cavopulmonary connection (TCPC).

Methods

Subjects consisted of 161 pediatric patients with single ventricles and 80 normal children without heart disease. The maximum positive rate of ventricular pressure change (Max dp/dt) was obtained in 58 patients by cardiac catheterization. Sixty-eight children with single ventricles received TCPC. MPI was calculated from Doppler tracings of ventricular inflow and outflow, then MPI of single ventricles before and after surgery and normal heart were compared.

Results

Normal MPI value was 0.30±0.08 in the left ventricle and 0.26±0.08 in the right ventricle. Compared to normal children, MPI was significantly higher in 161 children with single ventricles (0.54±0.11, P<0.001). MPI correlated inversely with Max (dp/dt) (r=−0.77, P<0.01), and was positively related to age (r=0.54, P<0.01) in patients with single ventricles. MPI did not differ significantly before and after surgery in 68 patients with single ventricles (0.55±0.21 vs 0.51±0.20, P>0.05). However, MPI in 48 patients of <6 years old decreased significantly (0.55±0.21 vs 0.48±0.18, P<0.05), suggesting improved ventricular function.

Conclusions

Compared to normal children, ventricular function is impaired in patients with single ventricles and may worsen with age. MPI provides an accurate method for assessing ventricular function in children with single ventricles before and after TCPC.

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References

  1. Williams RV, Ritter S, Tani LY, Pagotto LT, Minich LL. Quantitative assessment of ventricular function in children with single ventricles using the doppler myocardial performance index. Am J Cardiol 2000;86:1106–1110.

    Article  PubMed  CAS  Google Scholar 

  2. Donofrio MT, Jacobs ML, Spray TL, Rychik J. Acute changes in preload, afterload, and systolic function after superior cavopulmonary connection. Ann Thorac Surg 1998;65:503–508.

    Article  PubMed  CAS  Google Scholar 

  3. Zhang YQ, Chen SB, Sun K, Chen S, Shen R, Zhang ZF, et al. Study on right ventricular function in children with normal heart and congenital heart disease using the Doppler Tei index (chin). Chin J Med Imaging Techol 2003;19:1669–1671.

    Google Scholar 

  4. Tei C. New noninvasive index for combined systolic and diastolic ventricular function. J Cardiol 1995;26:135–136.

    PubMed  CAS  Google Scholar 

  5. Bruch C, Schmermund A, Dagres N, Katz M, Bartel T, Erbel R. Severe aortic valve stenosis with preserved and reduced systolic left ventricular function: diagnostic usefulness of the Tei index. J Am Soc Echocardiogr 2002;15:869–876.

    Article  PubMed  Google Scholar 

  6. Ishii M, Eto G, Tei C, Tsutsumi T, Hashino K, Sugahara Y, et al. Quantitation of the global right ventricular function in children with normal heart and congenital heart disease: a right ventricular myocardial performance index. Pediatr Cardiol 2000;21:416–421.

    Article  PubMed  CAS  Google Scholar 

  7. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307–310.

    PubMed  CAS  Google Scholar 

  8. McGuirk SP, Winlaw DS, Langley SM, Stumper OF, de Giovanni JV, Wright JG, et al. The impact of ventricular morphology on midterm outcome following completion total cavopulmonary connection. Eur J Cardiothorac Surg 2003;24:37–46.

    Article  PubMed  Google Scholar 

  9. Piran S, Veldtman G, Siu S, Webb GD, Liu PP. Heart failure and ventricular dysfunction in patients with single or systemic right ventricles. Circulation 2002;105:1189–1194.

    Article  PubMed  Google Scholar 

  10. Ricci M, Lombardi P, Galindo A, Vasquez A, Zuccarelli J, Rosenkranz E. Distribution of cardiac output and oxygen delivery in an acute animal model of single-ventricle physiology. J Thorac Cardiovasc Surg 2005;130:1062–1070.

    Article  PubMed  Google Scholar 

  11. Milanesi O, Stellin G, Colan SD, Facchin P, Crepaz R, Biffanti R, et al. Systolic and diastolic performance late after the Fontan procedure for a single ventricle and comparison of those undergoing operation at <12 months of age and at >12 months of age. Am J Cardiol 2002;89:276–280.

    Article  PubMed  Google Scholar 

  12. Mahle WT, Coon PD, Wernovsky G, Rychink J. Quantitative echocardiographic assessment of the performance of the functionally single right ventricle after the fontan operation. Cardiol Young 2001;11:399–406.

    Article  PubMed  CAS  Google Scholar 

  13. Murphy GS, Marymont JH, Szokol JW, Avram MJ, Vender JS. Correlation of the myocardial performance index with conventional echocardiographic indices of systolic and diastolic function: a study in cardiac surgical patients. Echocardiography 2007;24:26–33.

    Article  PubMed  Google Scholar 

  14. LaCorte JC, Cabreriza SE, Rabkin DG, Printz BF, Coku L, Weinberg A, et al. Correlation of the Tei index with invasive measurements of ventricular function in a porcine model. J Am Soc Echocardiogr 2003;16:442–447.

    Article  PubMed  Google Scholar 

  15. Ozkan M, Uzun M, Erinc K, Koz C, Baysan O, Sag C. Utility of myocardial performance index measured by left ventricular catheterization. Acta Cardiol 2005;60:415–420.

    Article  PubMed  Google Scholar 

  16. Teshima K, Asano K, Iwanaga K, Koie H, Uechi M, Kato Y, et al. Evaluation of left ventricular Tei index (index of myocardial performance) in healthy dogs and dogs with mitral regurgitation. J Vet Med Sci 2007;69:117–123.

    Article  PubMed  Google Scholar 

  17. Spencer KT, Kirkpatrick JN, Mor-Avi V, Decara JM, Lang RM. Age dependency of the Tei index of myocardial performance. J Am Soc Echocardiogr 2004;17:350–352.

    Article  PubMed  Google Scholar 

  18. Hori Y, Uechi M, Indou A. Effects of changes in loading conditions and heart rate on the myocardial performance index in cats. Am J Vet Res 2007;68:1183–1187.

    Article  PubMed  Google Scholar 

  19. Voon WC, Su HM, Yen HW, Lin TH, Lai WT, Sheu SH. Left ventricular Tei index: comparison between flow and tissue Doppler analyses. Echocardiography 2005;22:730–735.

    Article  PubMed  Google Scholar 

  20. Mahle WT, Cohen MS, Spray TL, Rychik J. Atrioventricular valve regurgitation in patients with single ventricle: impact of the bidirectional cavopulmonary anastomosis. Ann Thorac Surg 2001;72:831–835.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Cardiology, Shanghai Children’s Medical Center, Shanghai Jiaotong University, Shanghai, 200127, China

    Yu-Qi Zhang, Kun Sun, Shan-Liang Zhu, Lan-Ping Wu, Guo-Zhen Chen, Zhi-Fang Zhang, Sun Chen, Fen Li & Xiao-Lei Yi

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  1. Yu-Qi Zhang
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  2. Kun Sun
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  3. Shan-Liang Zhu
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  4. Lan-Ping Wu
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  5. Guo-Zhen Chen
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  6. Zhi-Fang Zhang
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  7. Sun Chen
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  8. Fen Li
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  9. Xiao-Lei Yi
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Correspondence to Kun Sun.

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Zhang, YQ., Sun, K., Zhu, SL. et al. Doppler myocardial performance index in assessment of ventricular function in children with single ventricles. World J Pediatr 4, 109–113 (2008). https://doi.org/10.1007/s12519-008-0021-y

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  • DOI: https://doi.org/10.1007/s12519-008-0021-y

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