Validation of Noninvasive Measures of Left Ventricular Mechanics in Children: A Simultaneous Echocardiographic and Conductance Catheterization Study

Shahryar M. Chowdhury, Ryan J. Butts, Carolyn L. Taylor, Varsha M. Bandisode, Karen S. Chessa, Anthony M. Hlavacek, Girish S. Shirali, G. Hamilton Baker

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)640-647
Number of pages8
JournalJournal of the American Society of Echocardiography
Volume29
Issue number7
DOIs
StatePublished - Jul 1 2016

Fingerprint

Mechanics
Catheterization
Gold
Catheters
Three-Dimensional Echocardiography
Balloon Occlusion
Pressure
Venae Cavae
Patent Ductus Arteriosus
Cardiac Catheterization
Fistula
Echocardiography
Anesthetics
Reading
Blood Pressure

Keywords

  • contractility
  • echocardiography
  • pediatric
  • Pressure-volume relationship

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Validation of Noninvasive Measures of Left Ventricular Mechanics in Children : A Simultaneous Echocardiographic and Conductance Catheterization Study. / Chowdhury, Shahryar M.; Butts, Ryan J.; Taylor, Carolyn L.; Bandisode, Varsha M.; Chessa, Karen S.; Hlavacek, Anthony M.; Shirali, Girish S.; Baker, G. Hamilton.

In: Journal of the American Society of Echocardiography, Vol. 29, No. 7, 01.07.2016, p. 640-647.

Research output: Contribution to journalArticle

Chowdhury, Shahryar M. ; Butts, Ryan J. ; Taylor, Carolyn L. ; Bandisode, Varsha M. ; Chessa, Karen S. ; Hlavacek, Anthony M. ; Shirali, Girish S. ; Baker, G. Hamilton. / Validation of Noninvasive Measures of Left Ventricular Mechanics in Children : A Simultaneous Echocardiographic and Conductance Catheterization Study. In: Journal of the American Society of Echocardiography. 2016 ; Vol. 29, No. 7. pp. 640-647.
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abstract = "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.",
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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

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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.

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KW - pediatric

KW - Pressure-volume relationship

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