title: Correlations Between Echocardiographic Systolic and Diastolic Function with Cardiac Catheterization in Biventricular Congenital Heart Patients.
abstract: Newer echocardiographic techniques may allow for more accurate assessment of left ventricular (LV) function. Adult studies have correlated these echocardiographic measurements with invasive data, but minimal data exist in the pediatric congenital heart population. Purpose of this study was to evaluate which echocardiographic measurements correlated best with LV systolic and diastolic catheterization parameters. Patients with two-ventricle physiology who underwent simultaneous echocardiogram and cardiac catheterization were included. Images were obtained in the four-chamber view. LV systolic echocardiographic data included ejection fraction, displacement, tissue Doppler imaging (TDI) s' wave, global longitudinal strain, and strain rate (SR) s' wave. Diastolic echocardiographic data included mitral E and A waves, TDI e' and a' waves, and SRe' and SRa' waves. E/TDI e', TDI e'/TDI a', E/SRe', and SRe'/SRa' ratios were also calculated. Catheterization dP/dt was used as a marker for systolic function, and LV end-diastolic pressure (EDP) was used as a marker for diastolic function. Correlations of the echocardiographic and catheterization values were performed using Pearson correlation. Twenty-nine patients were included (14 females, 15 males). Median age at catheterization was 3.4 years (0.04-17.4 years). dP/dt was 1258 ± 353 mmHg/s, and LVEDP was 10.8 ± 2.4 mmHg. There were no significant correlations between catheterization dP/dt and systolic echocardiographic parameters. LVEDP correlated significantly with SRe' (r = -0.4, p = 0.03), SRa' (r = -0.4, p = 0.03), and E/SRe' (r = 0.5, p = 0.004). In pediatric congenital heart patients, catheterization dP/dt did not correlate with echocardiographic measurements of LV systolic function. Further studies are needed to determine which echocardiographic parameter best describes LV systolic function in this population. Strain rate analysis significantly correlated with LVEDP. Strain rate analysis should be considered as an alternative method to estimate LVEDP in this patient population.
authors.affiliation: Heart Center, Nationwide Children's Hospital, Columbus, OH, USA. holly.nadorlik@nationwidechildrens.org.
authors.forename: H
authors.initials: H
authors.lastname: Nadorlik
authors.affiliation: Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: C
authors.initials: C
authors.lastname: Stiver
authors.affiliation: Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: S
authors.initials: S
authors.lastname: Khan
authors.affiliation: Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Miao
authors.affiliation: Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: R
authors.initials: R
authors.lastname: Holzer
authors.affiliation: Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Cheatham
authors.affiliation: Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Cua
mesh_terms: D000293:Adolescent; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D013318:Stroke Volume; D013599:Systole; D016277:Ventricular Function, Left
keywords: Cardiac function; Catheterization; Congenital heart disease; Echocardiography; Strain and strain rate