title: Speckle-Tracking Echocardiographic Measures of Right Ventricular Diastolic Function Correlate with Reference Standard Measures Before and After Preload Alteration in Children.
abstract: The accuracy of echocardiographic measures of right ventricular (RV) diastolic function has been sparsely studied. Our objective was to evaluate the correlation between echocardiographic and reference standard measures of RV diastolic function derived from micromanometer pressure analysis before and after preload alteration in children. Echocardiograms and micromanometer pressure analyses were prospectively performed before and after fluid bolus in children undergoing right heart catheterization. The isovolumic relaxation time constant (τ) and end-diastolic pressure (EDP) were measured. Conventional and speckle-tracking echocardiographic (STE) parameters of RV systolic and diastolic function were assessed. Normal saline bolus was given to increase RV EDP by 20 %. Twenty-eight studies were performed in 22 patients with congenital heart disease or postheart transplantation. Mean age was 8.7 ± 6.1 years. RV longitudinal early diastolic strain rate (EDSR) correlated with τ before (r = 0.57, p = 0.001) and after fluid bolus (r = 0.48, p = 0.008). No conventional echocardiographic measures correlated with τ both before and after fluid bolus. Multiple regression analysis revealed RV EDSR and LV circumferential EDSR as independent predictors of RV τ. There were no independent predictors of EDP. RV EDSR appears to correlate with the reference standard measure of early active ventricular relaxation in children at baseline and after changes in preload. Conventional echocardiographic measures of diastolic function were not predictive of diastolic function after preload alteration. Future studies should assess the prognostic significance of STE measures of diastolic function in this population.
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, 165 Ashley Ave, MSC 915, Charleston, SC, 29425, USA. chowdhur@musc.edu.
authors.forename: Shahryar M
authors.initials: SM
authors.lastname: Chowdhury
authors.affiliation: The Ward Family Heart Center, Children's Mercy Hospital, Kansas City, MO, USA.
authors.forename: Suma P
authors.initials: SP
authors.lastname: Goudar
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, 165 Ashley Ave, MSC 915, Charleston, SC, 29425, USA.
authors.forename: G Hamilton
authors.initials: GH
authors.lastname: Baker
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, 165 Ashley Ave, MSC 915, Charleston, SC, 29425, USA.
authors.forename: Carolyn L
authors.initials: CL
authors.lastname: Taylor
authors.affiliation: The Ward Family Heart Center, Children's Mercy Hospital, Kansas City, MO, USA.
authors.forename: Girish S
authors.initials: GS
authors.lastname: Shirali
authors.affiliation: Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Mark K
authors.initials: MK
authors.lastname: Friedberg
authors.affiliation: Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Andreea
authors.initials: A
authors.lastname: Dragulescu
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, 165 Ashley Ave, MSC 915, Charleston, SC, 29425, USA.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Chessa
authors.affiliation: Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Luc
authors.initials: L
authors.lastname: Mertens
mesh_terms: D000293:Adolescent; D001810:Blood Volume / Q000502:physiology; D006328:Cardiac Catheterization / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003971:Diastole; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008365:Manometry; D011446:Prospective Studies; D012015:Reference Standards; D012965:Sodium Chloride / Q000008:administration & dosage; D016278:Ventricular Function, Right / Q000502:physiology*
chemical_list: D012965:Sodium Chloride
keywords: Congenital heart defects; Diastole; Echocardiography; Pediatrics