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Echocardiographic right ventricular function correlations with cardiac catheterisation data in biventricular congenital heart patients

Published online by Cambridge University Press:  30 March 2017

Holly Nadorlik ,
Corey Stiver ,
Sairah Khan ,
Yongjie Miao ,
Ralf Holzer ,
John P. Cheatham  and
Clifford L. Cua
Holly Nadorlik
Affiliation:
Heart Center, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
Corey Stiver
Affiliation:
Heart Center, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
Sairah Khan
Affiliation:
Heart Center, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
Yongjie Miao
Affiliation:
Heart Center, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
Ralf Holzer
Affiliation:
Heart Center, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
John P. Cheatham
Affiliation:
Heart Center, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
Clifford L. Cua*
Affiliation:
Heart Center, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
*
Correspondence to: C. Cua, MD, Heart Center, Nationwide Children’s Hospital, Columbus, 43205-2696 Ohio, United States of America. Tel: 614 722 2530; Fax: +614 722 2549; E-mail: [email protected]
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Abstract

Background

Newer echocardiographic techniques may allow for more accurate assessment of right ventricular function. Adult studies have correlated these echocardiographic measurements with invasive data, but minimal data exist in the paediatric congenital heart population. The purpose of this study was to evaluate echocardiographic measurements that correlate best with right ventricular systolic and diastolic catheterisation parameters.

Methods

Patients with two-ventricle physiology who underwent simultaneous echocardiogram and cardiac catheterisation were included in this study. Right ventricular systolic echocardiographic data included fractional area change, displacement, tissue Doppler imaging s’ wave, global longitudinal strain, and strain rate s’ wave. Diastolic echocardiographic data included tricuspid E and A waves, tissue Doppler imaging e’ and a’ waves, and strain rate e’ and a’ waves. E/tissue Doppler imaging e’, tissue Doppler imaging e’/tissue Doppler imaging a’, E/strain rate e’, and strain rate e’/strain rate a’ ratios were also calculated. Catheterisation dP/dt was used as a marker for systolic function and right ventricular end-diastolic pressure for diastolic function.

Results

A total of 32 patients were included in this study. The median age at catheterisation was 3.1 years (0.3–17.6 years). The DP/dt was 493±327 mmHg/second, and the right ventricular end-diastolic pressure was 7.7±2.4 mmHg. There were no significant correlations between catheterisation dP/dt and systolic echocardiographic parameters. Right ventricular end-diastolic pressure correlated significantly with strain rate e’ (r=−0.4, p=0.02), strain rate a’ (r=−0.5, p=0.03), and E/tissue Doppler imaging e’ (r=0.4, p=0.04).

Conclusion

Catheterisation dP/dt did not correlate with echocardiographic measurements of right ventricular systolic function. Strain rate and tissue Doppler imaging analysis significantly correlated with right ventricular end-diastolic pressure. These values should be further studied to determine whether they may be used as an alternative method to estimate right ventricular end-diastolic pressure in this patient population.

Keywords

EchocardiographycatheterisationCHDcardiac functionstrain and strain rate
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 6 , August 2017 , pp. 1186 - 1193
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Copyright
© Cambridge University Press 2017 

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