Regional myocardial function in children with chronic aortic regurgitation.
OBJECTIVE
To determine the influence of volume overload on regional myocardial function in children with aortic regurgitation (AR) using tissue Doppler echocardiography and strain rate imaging (TDE/SRI).


METHODS
Thirty children with AR (median age 14 years (range 3-28 years)) were divided into three groups: mild (n = 6), moderate (n = 15), and severe AR (n = 9). Patients and 30 matched healthy controls underwent echocardiography with TDE/SRI. Cineloops were acquired from parasternal long- and short-axis and from apical four- and two-chamber views. The following parameters were extracted: peak systolic (V(S) ) and diastolic (V(E) ) velocities, peak systolic strain (S), peak systolic (SR(S) ), and early diastolic strain rate (SR(E) ). To quantify longitudinal LV function, V(S) and V(E) were obtained as peak values in the basal segments, whereas S, SR(S) , and SR(E) were expressed as mean values between basal and midwall segments.


RESULTS
Compared to the control group, patients showed a significant reduction in V(E) in the longitudinal direction (-91 ± 30 mm/sec for patients vs. 119 ± 20 mm/sec for control group). In patients with severe AR, longitudinal SR(E) was significantly reduced. On the other hand, we noted no differences between patients and controls with regard to S and SR(S) values.


CONCLUSIONS
Children with AR presented with significantly reduced longitudinal diastolic function (V(E) ). Severe AR leads to a decrease in diastolic myocardial deformation (SR(E) ). Due to the short duration of AR in this group of patients, systolic function (SR(S) ) is still preserved.
Goebel
Björn
B
Department of Medicine I, University Hospital Jena, Mathildenstrasse 1, Jena, Germany.
Poerner
Tudor
T
Gorenflo
Matthias
M
Lauten
Alexander
A
Jung
Christian
C
Grohmann
Jochen
J
Figulla
Hans
H
Arnold
Raoul
R
D000293:Adolescent; D000328:Adult; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology*; D002675:Child, Preschool; D002908:Chronic Disease; D015150:Echocardiography, Doppler / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology*; D055815:Young Adult