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Comparison of echocardiographic measurements to invasive measurements of diastolic function in infants with single ventricle physiology: a report from the Pediatric Heart Network Infant Single Ventricle Trial

Part of: Pediatric Heart Network

Published online by Cambridge University Press:  03 September 2019

Suma P. Goudar Open the ORCID record for Suma P. Goudar [Opens in a new window] ,
Victor Zak Open the ORCID record for Victor Zak [Opens in a new window] ,
Andrew M. Atz ,
Karen Altmann ,
Steven D. Colan ,
Christine B. Falkensammer ,
Mark K. Friedberg ,
Michele Frommelt ,
Kevin D. Hill  and
Daphne T. Hsu
...Show all authors
Suma P. Goudar*
Affiliation:
Department of Cardiology, Ward Family Heart Center, Children’s Mercy Hospital, Kansas City, MO, USA
Victor Zak
Affiliation:
New England Research Institute, Watertown, MA, USA
Andrew M. Atz
Affiliation:
Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC, USA
Karen Altmann
Affiliation:
Division of Pediatric Cardiology, Columbia University Medical Center, New York, NY, USA
Steven D. Colan
Affiliation:
Boston Children’s Hospital, Boston, MA, USA
Christine B. Falkensammer
Affiliation:
Children’s Hospital Philadelphia, Philadelphia, PA, USA
Mark K. Friedberg
Affiliation:
Division of Pediatric Cardiology, The Hospital for Sick Children, Toronto, ON, Canada
Michele Frommelt
Affiliation:
Children’s Hospital of Wisconsin, Milwaukee, WI, USA
Kevin D. Hill
Affiliation:
Duke University, Durham, NC, USA
Daphne T. Hsu
Affiliation:
Children’s Hospital at Montefiore, Bronx, NY, USA
Jami C. Levine
Affiliation:
Boston Children’s Hospital, Boston, MA, USA
Renee Margossian
Affiliation:
Boston Children’s Hospital, Boston, MA, USA
Christopher R. Mart
Affiliation:
Primary Children’s Medical Hospital, Salt Lake City, UT, USA
Joshua Sticka
Affiliation:
Cincinnati Children’s Hospital, Cincinnati, OH, USA
Peter Shrader
Affiliation:
New England Research Institute, Watertown, MA, USA
Girish Shirali
Affiliation:
Department of Cardiology, Ward Family Heart Center, Children’s Mercy Hospital, Kansas City, MO, USA
for the Pediatric Heart Network Investigators
Affiliation:
Department of Cardiology, Ward Family Heart Center, Children’s Mercy Hospital, Kansas City, MO, USA New England Research Institute, Watertown, MA, USA Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC, USA Division of Pediatric Cardiology, Columbia University Medical Center, New York, NY, USA Boston Children’s Hospital, Boston, MA, USA Children’s Hospital Philadelphia, Philadelphia, PA, USA Division of Pediatric Cardiology, The Hospital for Sick Children, Toronto, ON, Canada Children’s Hospital of Wisconsin, Milwaukee, WI, USA Duke University, Durham, NC, USA Children’s Hospital at Montefiore, Bronx, NY, USA Primary Children’s Medical Hospital, Salt Lake City, UT, USA Cincinnati Children’s Hospital, Cincinnati, OH, USA
*
Author for correspondence: S. P. Goudar, Ward Family Heart Center, Children’s Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA. Tel: +1 (816)234-3255; Fax: +1 (816)234-3701; E-mail: [email protected]
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Abstract

Background:

While echocardiographic parameters are used to quantify ventricular function in infants with single ventricle physiology, there are few data comparing these to invasive measurements. This study correlates echocardiographic measures of diastolic function with ventricular end-diastolic pressure in infants with single ventricle physiology prior to superior cavopulmonary anastomosis.

Methods:

Data from 173 patients enrolled in the Pediatric Heart Network Infant Single Ventricle enalapril trial were analysed. Those with mixed ventricular types (n = 17) and one outlier (end-diastolic pressure = 32 mmHg) were excluded from the analysis, leaving a total sample size of 155 patients. Echocardiographic measurements were correlated to end-diastolic pressure using Spearman’s test.

Results:

Median age at echocardiogram was 4.6 (range 2.5–7.4) months. Median ventricular end-diastolic pressure was 7 (range 3–19) mmHg. Median time difference between the echocardiogram and catheterisation was 0 days (range −35 to 59 days). Examining the entire cohort of 155 patients, no echocardiographic diastolic function variable correlated with ventricular end-diastolic pressure. When the analysis was limited to the 86 patients who had similar sedation for both studies, the systolic:diastolic duration ratio had a significant but weak negative correlation with end-diastolic pressure (r = −0.3, p = 0.004). The remaining echocardiographic variables did not correlate with ventricular end-diastolic pressure.

Conclusion:

In this cohort of infants with single ventricle physiology prior to superior cavopulmonary anastomosis, most conventional echocardiographic measures of diastolic function did not correlate with ventricular end-diastolic pressure at cardiac catheterisation. These limitations should be factored into the interpretation of quantitative echo data in this patient population.

Keywords

Diastolic functioninfantssingle ventricle
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 10 , October 2019 , pp. 1248 - 1256
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Copyright
© Cambridge University Press 2019 

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