title: Tissue Doppler measurements correlate with central venous pressure in pediatric patients after cardiac surgery.
abstract: Tissue Doppler imaging (TDI) measurements have been demonstrated to correlate with central venous pressure (CVP) in adults. We hypothesize that TDI measurements also correlate with CVP in children after cardiac surgery. Patients younger than 10 years with invasive CVP monitoring after cardiac surgery were studied. Annular tissue and atrioventricular inflow velocities were measured daily during CVP monitoring. Tissue Doppler imaging measurements were compared with CVP by univariate analyses. Subgroup analyses were performed for univentricular versus biventricular hearts. p values < or = 0.05 were considered significant. Fifty studies were performed on 28 subjects; 20 studies were performed on patients with univentricular physiology; and 30 studies were performed on patients with biventricular physiology. For all subjects, CVP correlated significantly with the right ventricular TDI measurements of e' velocity (r = -0.43), a' velocity (r = 0.35), e'/a' ratio (r = -0.42), and E/e' ratio (r = 0.44). For biventricular patients, e' velocity (r = -0.35), e'/a' ratio (r = -0.38), and E/e' ratio (r = 0.58) correlated significantly. For univentricular patients, E velocity (r = -0.62), e' velocity (r = -0.50), and a' (r = 0.61) velocity correlated significantly. Tissue Doppler imaging measurements of the right heart significantly correlated with invasively measured CVP in pediatric subjects. Different measures may correlate more strongly in those with biventricular versus univentricular physiology. With additional study, TDI may prove a valid tool for noninvasively assessing CVP in children with both bi- and univentricular physiology.
authors.affiliation: The Heart Center, Nationwide Children's Hospital and Research Institute, Columbus, Ohio, USA.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Learn
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Yates
authors.forename: Lisa
authors.initials: L
authors.lastname: Nicholson
authors.forename: Keyana
authors.initials: K
authors.lastname: Milton
authors.forename: Eric
authors.initials: E
authors.lastname: Lloyd
authors.forename: Clifford L
authors.initials: CL
authors.lastname: Cua
mesh_terms: D006348:Cardiac Surgical Procedures; D002496:Central Venous Pressure; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D008297:Male