title: Use of myocardial performance index in pediatric patients with idiopathic pulmonary arterial hypertension.
abstract: BACKGROUND
  The myocardial performance index (MPI) correlates with clinical status in adults with idiopathic pulmonary arterial (PA) hypertension (IPAH). This pediatric study used MPI to assess response to bosentan therapy.
  
  
  METHODS
  The study included 12 children with IPAH and 12 healthy control subjects. MPI was correlated with catheterization data at initiation of bosentan and at a median follow-up of 9 months. Therapy responders were defined by a greater than 20% decrease in mean PA pressure.
  
  
  RESULTS
  Right ventricular MPI for patients with IPAH was 0.64 +/- 0.30 versus 0.28 +/- 0.03 in control subjects (P < .01). It had a strong correlation with mean PA pressure (R = 0.94; P < .001). Right ventricular MPI decreased significantly in responders (range 20%-44%, mean 25%) with a 5% increase in nonresponders.
  
  
  CONCLUSIONS
  Right ventricular MPI in pediatric IPAH correlates with mean PA pressure and response to therapy. This study suggests that this noninvasive Doppler index may be useful to follow up children with IPAH, particularly when tricuspid regurgitation data are insufficient.
authors.affiliation: University of Colorado Health Sciences Center--The Children's Hospital, Denver, Colorado, USA. dyer.karrie@tchden.org
authors.forename: Karrie L
authors.initials: KL
authors.lastname: Dyer
authors.forename: Linda B
authors.initials: LB
authors.lastname: Pauliks
authors.forename: Bibhuti
authors.initials: B
authors.lastname: Das
authors.forename: Robin
authors.initials: R
authors.lastname: Shandas
authors.forename: Dunbar
authors.initials: D
authors.lastname: Ivy
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Shaffer
authors.forename: Lilliam M
authors.initials: LM
authors.lastname: Valdes-Cruz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D010372:Pediatrics / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology