Pre- and postoperative quantitation of right ventricular tissue Doppler velocities in infants with hypoplastic left heart syndrome.
BACKGROUND
The purpose of this study was to use tissue Doppler imaging (TDI) to serially quantitate initial and preoperative right ventricular (RV) TDI velocities and compare them to postoperative RV TDI velocities as measures of RV function in newborns with hypoplastic left heart syndrome (HLHS).


METHODS
Twelve consecutive patients were prospectively studied with diagnosis of HLHS. Systolic (Sw) and early diastolic (Ew) velocities were recorded at the tricuspid annulus and the ventricular septum at (1) admission, (2) immediately preoperative, and (3) during recovery. All patients were treated preoperatively with prostaglandins (PGE). Velocities were compared using repeated measure analysis of variance.


RESULTS
Mean age at diagnosis was 1 day (0-4 days). Time from diagnosis to surgery was 4 days (1-9 days), age at surgery 5.3 days (2-10 days), and time from surgery to postoperative echo 12.3 days (5-19 days). Tricuspid annular and septal systolic velocities increased from admission to preoperative. Both tricuspid Sw and Ew and septal Sw velocities decreased postoperatively. No significant changes occurred in the ventricular septal diastolic (Ew) velocities from admission to preoperative.


CONCLUSIONS
These data indicate that following the institution of PGE and initial medical and ventilatory management, there is an increase in RV annular and septal systolic velocities from the initial to the preoperative period and that these indices as well as RV annular diastolic velocities decline significantly postoperatively. Initial septal diastolic velocities were severely abnormal and did not significantly change pre- and postoperatively. These data may have significance for both postoperative and subsequent long-term RV function.
Christensen
Douglas
D
Children's Healthcare of Atlanta, and Emory University, Atlanta, Georgia 30329, USA. douglas_christensen@pediatrix.com
Cardis
Brian
B
Mahle
William
W
Lewis
Reginald
R
Huckaby
Jeryl
J
Favaloro-Sabatier
Jennifer
J
Fyfe
Derek
D
D001783:Blood Flow Velocity; D015150:Echocardiography, Doppler; D006346:Heart Septum / Q000503:physiopathology*; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007231:Infant, Newborn; D009200:Myocardial Contraction / Q000502:physiology*; D011446:Prospective Studies; D011453:Prostaglandins / Q000008:administration & dosage; D014261:Tricuspid Valve / Q000503:physiopathology*; D016278:Ventricular Function, Right / Q000502:physiology*
D011453:Prostaglandins