title: Diastolic dysfunction measured by tissue Doppler imaging in children with end-stage renal disease: a report of the RICH-Q study.
abstract: BACKGROUND
  Early detection of cardiovascular disease in children with end-stage renal disease is essential in order to prevent cardiovascular morbidity and mortality in early adulthood. Tissue Doppler imaging has shown to be a promising method to detect and quantify subtle abnormalities in diastolic function. We therefore compared assessment of diastolic function by conventional echocardiography and tissue Doppler imaging.
  
  
  METHODS
  We performed conventional echocardiography and tissue Doppler imaging in 38 children with end-stage renal disease and 76 healthy controls. We compared outcomes on parameters related to diastolic function (E/a ratio for conventional echocardiography and E/E' ratio for tissue Doppler imaging) for both groups using multiple linear regression analysis. Diastolic dysfunction was defined as E/a ratio <1 or E/E' ratio > 95th percentile for age. To assess the intra-observer reproducibility, the coefficient of variation was calculated.
  
  
  RESULTS
  Children with end-stage renal disease had on average a lower E/a ratio (p = 0.004) and a higher mitral and septal E/E' ratio (both p < 0.001) compared with controls. In all, two children with end-stage renal disease (5%) had diastolic dysfunction according to the E/a ratio, 11 according to the mitral E/E' ratio (29%), and 16 according to the septal E/E' ratio (42%) compared with none of the controls (p = 0.109, p < 0.001, and p < 0.001, respectively). The coefficients of variation of the mitral (7%) and septal E/E' ratio (4%) were smaller than the coefficient of variation of the E/a ratio (11%).
  
  
  CONCLUSIONS
  Tissue Doppler imaging is a more sensitive and reliable method to detect diastolic dysfunction than conventional E/a ratio in children with end-stage renal disease.
authors: 1 Department of Paediatric Nephrology, Emma Children's Hospital AMC Amsterdam, The Netherlands.
authors: Nikki J
authors: NJ
authors: Schoenmaker
authors: 2 Department of Paediatric Cardiology, Emma Children's Hospital AMC Amsterdam, The Netherlands.
authors: Irene M
authors: IM
authors: Kuipers
authors: 3 Department of Paediatric Clinical Epidemiology, Emma Children's Hospital AMC Amsterdam, The Netherlands.
authors: Johanna H
authors: JH
authors: van der Lee
authors: 1 Department of Paediatric Nephrology, Emma Children's Hospital AMC Amsterdam, The Netherlands.
authors: Wilma F
authors: WF
authors: Tromp
authors: 4 Department of Paediatric Nephrology, University Hospital Leuven, Belgium.
authors: Maria
authors: M
authors: van Dyck
authors: 5 Department of Paediatric Cardiology, University Hospital Leuven, Belgium.
authors: Marc
authors: M
authors: Gewillig
authors: 2 Department of Paediatric Cardiology, Emma Children's Hospital AMC Amsterdam, The Netherlands.
authors: Nico A
authors: NA
authors: Blom
authors: 1 Department of Paediatric Nephrology, Emma Children's Hospital AMC Amsterdam, The Netherlands.
authors: Jaap W
authors: JW
authors: Groothoff
mesh_terms: D000293:Adolescent; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003971:Diastole; D004452:Echocardiography / Q000379:methods; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications*; D016014:Linear Models; D008297:Male; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology