TY - JOUR
T1 - Validation of Noninvasive Measures of Left Ventricular Mechanics in Children
T2 - A Simultaneous Echocardiographic and Conductance Catheterization Study
AU - Chowdhury, Shahryar M.
AU - Butts, Ryan J.
AU - Taylor, Carolyn L.
AU - Bandisode, Varsha M.
AU - Chessa, Karen S.
AU - Hlavacek, Anthony M.
AU - Shirali, Girish S.
AU - Baker, G. Hamilton
N1 - Publisher Copyright:
© 2016 American Society of Echocardiography
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Background The accuracy of echocardiography in evaluating left ventricular contractility has not been validated in children. The objective of this study was to compare echocardiographic measures of contractility with those derived from pressure-volume loop (PVL) analysis in children. Methods Patients with relatively normal loading conditions undergoing routine left heart catheterization were prospectively enrolled. PVLs were obtained via conductance catheters. The gold-standard measure of contractility, end-systolic elastance (Ees), was obtained via balloon occlusion of one or both vena cavae. Echocardiograms were performed immediately after PVL analysis under the same anesthetic conditions. Single-beat estimations of echocardiographic Ees were calculated using four different methods. These estimates were calculated using a combination of noninvasive blood pressure readings, ventricular volumes derived from three-dimensional echocardiography, and Doppler time intervals. Results Of 24 patients, 18 patients were heart transplant recipients, and six patients had small patent ductus arteriosus or small coronary fistulae. The mean age was 9.1 ± 5.6 years. The average invasive Ees was 3.04 ± 1.65 mm Hg/mL. Invasive Ees correlated best with echocardiographic Ees by the method of Tanoue (r = 0.85, P < .01), with a mean difference of −0.07 mm Hg/mL (95% limits of agreement, −2.0 to 1.4 mm Hg/mL). Conclusions Echocardiographic estimates of Ees correlate well with gold-standard measures obtained via conductance catheters in children with relatively normal loading conditions. The use of these noninvasive measures in accurately assessing left ventricular contractility appears promising and merits further study in children.
AB - Background The accuracy of echocardiography in evaluating left ventricular contractility has not been validated in children. The objective of this study was to compare echocardiographic measures of contractility with those derived from pressure-volume loop (PVL) analysis in children. Methods Patients with relatively normal loading conditions undergoing routine left heart catheterization were prospectively enrolled. PVLs were obtained via conductance catheters. The gold-standard measure of contractility, end-systolic elastance (Ees), was obtained via balloon occlusion of one or both vena cavae. Echocardiograms were performed immediately after PVL analysis under the same anesthetic conditions. Single-beat estimations of echocardiographic Ees were calculated using four different methods. These estimates were calculated using a combination of noninvasive blood pressure readings, ventricular volumes derived from three-dimensional echocardiography, and Doppler time intervals. Results Of 24 patients, 18 patients were heart transplant recipients, and six patients had small patent ductus arteriosus or small coronary fistulae. The mean age was 9.1 ± 5.6 years. The average invasive Ees was 3.04 ± 1.65 mm Hg/mL. Invasive Ees correlated best with echocardiographic Ees by the method of Tanoue (r = 0.85, P < .01), with a mean difference of −0.07 mm Hg/mL (95% limits of agreement, −2.0 to 1.4 mm Hg/mL). Conclusions Echocardiographic estimates of Ees correlate well with gold-standard measures obtained via conductance catheters in children with relatively normal loading conditions. The use of these noninvasive measures in accurately assessing left ventricular contractility appears promising and merits further study in children.
KW - Pressure-volume relationship
KW - contractility
KW - echocardiography
KW - pediatric
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U2 - 10.1016/j.echo.2016.02.016
DO - 10.1016/j.echo.2016.02.016
M3 - Article
C2 - 27025669
AN - SCOPUS:84961773697
SN - 0894-7317
VL - 29
SP - 640
EP - 647
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 7
ER -