Skip to main content
Erschienen in: Pediatric Cardiology 2/2017

23.11.2016 | Original Article

Utility of Echocardiography in the Assessment of Left Ventricular Diastolic Function and Restrictive Physiology in Children and Young Adults with Restrictive Cardiomyopathy: A Comparative Echocardiography-Catheterization Study

verfasst von: Thomas D. Ryan, Peace C. Madueme, John L. Jefferies, Erik C. Michelfelder, Jeffrey A. Towbin, Jessica G. Woo, Rashmi D. Sahay, Eileen C. King, Roberta Brown, Ryan A. Moore, Michelle A. Grenier, Bryan H. Goldstein

Erschienen in: Pediatric Cardiology | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

The aim of the study is to determine the utility of echocardiography in the assessment of diastolic function in children and young adults with restrictive cardiomyopathy (RCM). RCM is a rare disease with high mortality requiring frequent surveillance. Accurate, noninvasive echocardiographic measures of diastolic function may reduce the need for invasive catheterization. Single-center, prospective, observational study of pediatric and young adult RCM patients undergoing assessment of diastolic parameters by simultaneous transthoracic echocardiogram (TTE) and invasive catheterization. Twenty-one studies in 15 subjects [median (IQR) = 13.8 years (7.0–19.2), 60% female] were acquired with median left ventricular end-diastolic pressure (LVEDP) 21 (IQR 18–25) mmHg. TTE parameters of diastolic function, including pulmonary vein A wave duration (r s  = 0.79) and indexed left atrial volume (r s  = 0.49), demonstrated significant positive correlation, while mitral valve A (r s  = −0.44), lateral e′ (r s  = −0.61) and lateral a′ (r s  = −0.61) velocities showed significant negative correlation with LVEDP. Lateral a′ velocity (≤0.042 m/s) and pulmonary vein A wave duration (≥156 m/s) both had sensitivity and specificity ≥80% for LVEDP ≥ 20 mmHg. In pediatric and young adult patients with RCM, lateral a′ velocity and pulmonary vein A wave duration predicted elevated LVEDP with high sensitivity and specificity; however, due to technical limitations the latter was reliably measured in 12/21 patients. These noninvasive parameters may have utility in identifying patients that require further assessment with invasive testing. These findings require validation in a multicenter prospective cohort prior to widespread clinical implementation.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Denfield SW, Webber SA (2010) Restrictive cardiomyopathy in childhood. Heart Fail Clin 6:445–452 (viii) CrossRefPubMed Denfield SW, Webber SA (2010) Restrictive cardiomyopathy in childhood. Heart Fail Clin 6:445–452 (viii) CrossRefPubMed
2.
Zurück zum Zitat Webber SA, Lipshultz SE, Sleeper LA, Lu M, Wilkinson JD, Addonizio LJ, Canter CE, Colan SD, Everitt MD, Jefferies JL, Kantor PF, Lamour JM, Margossian R, Pahl E, Rusconi PG, Towbin JA, Pediatric Cardiomyopathy Registry I (2012) Outcomes of restrictive cardiomyopathy in childhood and the influence of phenotype: a report from the pediatric cardiomyopathy registry. Circulation 126:1237–1244CrossRefPubMed Webber SA, Lipshultz SE, Sleeper LA, Lu M, Wilkinson JD, Addonizio LJ, Canter CE, Colan SD, Everitt MD, Jefferies JL, Kantor PF, Lamour JM, Margossian R, Pahl E, Rusconi PG, Towbin JA, Pediatric Cardiomyopathy Registry I (2012) Outcomes of restrictive cardiomyopathy in childhood and the influence of phenotype: a report from the pediatric cardiomyopathy registry. Circulation 126:1237–1244CrossRefPubMed
3.
Zurück zum Zitat Appleton CP, Hatle LK, Popp RL (1988) Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined hemodynamic and Doppler echocardiographic study. J Am Coll Cardiol 12:426–440CrossRefPubMed Appleton CP, Hatle LK, Popp RL (1988) Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined hemodynamic and Doppler echocardiographic study. J Am Coll Cardiol 12:426–440CrossRefPubMed
4.
Zurück zum Zitat Nagueh SF, Middleton KJ, Kopelen HA, Zoghbi WA, Quinones MA (1997) Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol 30:1527–1533CrossRefPubMed Nagueh SF, Middleton KJ, Kopelen HA, Zoghbi WA, Quinones MA (1997) Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol 30:1527–1533CrossRefPubMed
5.
Zurück zum Zitat Nagueh SF, Lakkis NM, Middleton KJ, Spencer WH 3rd, Zoghbi WA, Quinones MA (1999) Doppler estimation of left ventricular filling pressures in patients with hypertrophic cardiomyopathy. Circulation 99:254–261CrossRefPubMed Nagueh SF, Lakkis NM, Middleton KJ, Spencer WH 3rd, Zoghbi WA, Quinones MA (1999) Doppler estimation of left ventricular filling pressures in patients with hypertrophic cardiomyopathy. Circulation 99:254–261CrossRefPubMed
6.
Zurück zum Zitat Diwan A, McCulloch M, Lawrie GM, Reardon MJ, Nagueh SF (2005) Doppler estimation of left ventricular filling pressures in patients with mitral valve disease. Circulation 111:3281–3289CrossRefPubMed Diwan A, McCulloch M, Lawrie GM, Reardon MJ, Nagueh SF (2005) Doppler estimation of left ventricular filling pressures in patients with mitral valve disease. Circulation 111:3281–3289CrossRefPubMed
7.
Zurück zum Zitat Kasner M, Westermann D, Steendijk P, Gaub R, Wilkenshoff U, Weitmann K, Hoffmann W, Poller W, Schultheiss HP, Pauschinger M, Tschope C (2007) Utility of Doppler echocardiography and tissue Doppler imaging in the estimation of diastolic function in heart failure with normal ejection fraction: a comparative Doppler-conductance catheterization study. Circulation 116:637–647CrossRefPubMed Kasner M, Westermann D, Steendijk P, Gaub R, Wilkenshoff U, Weitmann K, Hoffmann W, Poller W, Schultheiss HP, Pauschinger M, Tschope C (2007) Utility of Doppler echocardiography and tissue Doppler imaging in the estimation of diastolic function in heart failure with normal ejection fraction: a comparative Doppler-conductance catheterization study. Circulation 116:637–647CrossRefPubMed
8.
Zurück zum Zitat Arteaga RB, Hreybe H, Patel D, Landolfo C (2008) Derivation and validation of a diagnostic model for the evaluation of left ventricular filling pressures and diastolic function using mitral annulus tissue Doppler imaging. Am Heart J 155:924–929CrossRefPubMed Arteaga RB, Hreybe H, Patel D, Landolfo C (2008) Derivation and validation of a diagnostic model for the evaluation of left ventricular filling pressures and diastolic function using mitral annulus tissue Doppler imaging. Am Heart J 155:924–929CrossRefPubMed
9.
Zurück zum Zitat Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, Flachskampf FA, Gillebert TC, Klein AL, Lancellotti P, Marino P, Oh JK, Popescu BA, Waggoner AD (2016) Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 29:277–314CrossRefPubMed Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, Flachskampf FA, Gillebert TC, Klein AL, Lancellotti P, Marino P, Oh JK, Popescu BA, Waggoner AD (2016) Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 29:277–314CrossRefPubMed
10.
Zurück zum Zitat Savage A, Hlavacek A, Ringewald J, Shirali G (2010) Evaluation of the myocardial performance index and tissue doppler imaging by comparison to near-simultaneous catheter measurements in pediatric cardiac transplant patients. J Heart Lung Transplant 29:853–858CrossRefPubMed Savage A, Hlavacek A, Ringewald J, Shirali G (2010) Evaluation of the myocardial performance index and tissue doppler imaging by comparison to near-simultaneous catheter measurements in pediatric cardiac transplant patients. J Heart Lung Transplant 29:853–858CrossRefPubMed
11.
Zurück zum Zitat Dragulescu A, Mertens L, Friedberg MK (2013) Interpretation of left ventricular diastolic dysfunction in children with cardiomyopathy by echocardiography: problems and limitations. Circ Cardiovasc Imaging 6:254–261CrossRefPubMed Dragulescu A, Mertens L, Friedberg MK (2013) Interpretation of left ventricular diastolic dysfunction in children with cardiomyopathy by echocardiography: problems and limitations. Circ Cardiovasc Imaging 6:254–261CrossRefPubMed
12.
Zurück zum Zitat Sasaki N, Garcia M, Ko HH, Sharma S, Parness IA, Srivastava S (2015) Applicability of published guidelines for assessment of left ventricular diastolic function in adults to children with restrictive cardiomyopathy: an observational study. Pediatr Cardiol 36:386–392CrossRefPubMed Sasaki N, Garcia M, Ko HH, Sharma S, Parness IA, Srivastava S (2015) Applicability of published guidelines for assessment of left ventricular diastolic function in adults to children with restrictive cardiomyopathy: an observational study. Pediatr Cardiol 36:386–392CrossRefPubMed
13.
Zurück zum Zitat Seckeler MD, Hirsch R, Beekman RH 3rd, Goldstein BH (2014) Validation of cardiac output using real-time measurement of oxygen consumption during cardiac catheterization in children under 3 years of age. Congenit Heart Dis 9:307–315CrossRefPubMed Seckeler MD, Hirsch R, Beekman RH 3rd, Goldstein BH (2014) Validation of cardiac output using real-time measurement of oxygen consumption during cardiac catheterization in children under 3 years of age. Congenit Heart Dis 9:307–315CrossRefPubMed
14.
Zurück zum Zitat Lopez L, Colan SD, Frommelt PC, Ensing GJ, Kendall K, Younoszai AK, Lai WW, Geva T (2010) Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 23:465–495 (quiz 576-467) CrossRefPubMed Lopez L, Colan SD, Frommelt PC, Ensing GJ, Kendall K, Younoszai AK, Lai WW, Geva T (2010) Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 23:465–495 (quiz 576-467) CrossRefPubMed
15.
Zurück zum Zitat Weller RJ, Weintraub R, Addonizio LJ, Chrisant MR, Gersony WM, Hsu DT (2002) Outcome of idiopathic restrictive cardiomyopathy in children. Am J Cardiol 90:501–506CrossRefPubMed Weller RJ, Weintraub R, Addonizio LJ, Chrisant MR, Gersony WM, Hsu DT (2002) Outcome of idiopathic restrictive cardiomyopathy in children. Am J Cardiol 90:501–506CrossRefPubMed
16.
Zurück zum Zitat Border WL, Michelfelder EC, Glascock BJ, Witt SA, Spicer RL, Beekman RH 3rd, Kimball TR (2003) Color M-mode and Doppler tissue evaluation of diastolic function in children: simultaneous correlation with invasive indices. J Am Soc Echocardiogr 16:988–994CrossRefPubMed Border WL, Michelfelder EC, Glascock BJ, Witt SA, Spicer RL, Beekman RH 3rd, Kimball TR (2003) Color M-mode and Doppler tissue evaluation of diastolic function in children: simultaneous correlation with invasive indices. J Am Soc Echocardiogr 16:988–994CrossRefPubMed
17.
Zurück zum Zitat Goldberg DJ, Quartermain MD, Glatz AC, Hall EK, Davis E, Kren SA, Hanna BD, Cohen MS (2011) Doppler tissue imaging in children following cardiac transplantation: a comparison to catheter derived hemodynamics. Pediatr Transplant 15:488–494CrossRefPubMedPubMedCentral Goldberg DJ, Quartermain MD, Glatz AC, Hall EK, Davis E, Kren SA, Hanna BD, Cohen MS (2011) Doppler tissue imaging in children following cardiac transplantation: a comparison to catheter derived hemodynamics. Pediatr Transplant 15:488–494CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Dipchand AI, Edwards LB, Kucheryavaya AY, Benden C, Dobbels F, Levvey BJ, Lund LH, Meiser B, Yusen RD, Stehlik J, International Society of H, Lung T (2014) The registry of the International Society for Heart and Lung Transplantation: seventeenth official pediatric heart transplantation report—2014. J Heart Lung Transplant 33:985–995CrossRefPubMed Dipchand AI, Edwards LB, Kucheryavaya AY, Benden C, Dobbels F, Levvey BJ, Lund LH, Meiser B, Yusen RD, Stehlik J, International Society of H, Lung T (2014) The registry of the International Society for Heart and Lung Transplantation: seventeenth official pediatric heart transplantation report—2014. J Heart Lung Transplant 33:985–995CrossRefPubMed
19.
Zurück zum Zitat Walsh MA, Grenier MA, Jefferies JL, Towbin JA, Lorts A, Czosek RJ (2012) Conduction abnormalities in pediatric patients with restrictive cardiomyopathy. Circ Heart Fail 5:267–273CrossRefPubMed Walsh MA, Grenier MA, Jefferies JL, Towbin JA, Lorts A, Czosek RJ (2012) Conduction abnormalities in pediatric patients with restrictive cardiomyopathy. Circ Heart Fail 5:267–273CrossRefPubMed
20.
Zurück zum Zitat Dagdelen S, Eren N, Karabulut H, Akdemir I, Ergelen M, Saglam M, Yuce M, Alhan C, Caglar N (2001) Estimation of left ventricular end-diastolic pressure by color M-mode Doppler echocardiography and tissue Doppler imaging. J Am Soc Echocardiogr 14:951–958CrossRefPubMed Dagdelen S, Eren N, Karabulut H, Akdemir I, Ergelen M, Saglam M, Yuce M, Alhan C, Caglar N (2001) Estimation of left ventricular end-diastolic pressure by color M-mode Doppler echocardiography and tissue Doppler imaging. J Am Soc Echocardiogr 14:951–958CrossRefPubMed
21.
Zurück zum Zitat Mi YP, Abdul-Khaliq H (2013) The pulsed Doppler and tissue Doppler-derived septal E/e’ ratio is significantly related to invasive measurement of ventricular end-diastolic pressure in biventricular rather than univentricular physiology in patients with congenital heart disease. Clin Res Cardiol 102:563–570CrossRefPubMed Mi YP, Abdul-Khaliq H (2013) The pulsed Doppler and tissue Doppler-derived septal E/e’ ratio is significantly related to invasive measurement of ventricular end-diastolic pressure in biventricular rather than univentricular physiology in patients with congenital heart disease. Clin Res Cardiol 102:563–570CrossRefPubMed
22.
Zurück zum Zitat Geske JB, Sorajja P, Nishimura RA, Ommen SR (2007) Evaluation of left ventricular filling pressures by Doppler echocardiography in patients with hypertrophic cardiomyopathy: correlation with direct left atrial pressure measurement at cardiac catheterization. Circulation 116:2702–2708CrossRefPubMed Geske JB, Sorajja P, Nishimura RA, Ommen SR (2007) Evaluation of left ventricular filling pressures by Doppler echocardiography in patients with hypertrophic cardiomyopathy: correlation with direct left atrial pressure measurement at cardiac catheterization. Circulation 116:2702–2708CrossRefPubMed
23.
Zurück zum Zitat Okumura K, Slorach C, Mroczek D, Dragulescu A, Mertens L, Redington AN, Friedberg MK (2014) Right ventricular diastolic performance in children with pulmonary arterial hypertension associated with congenital heart disease: correlation of echocardiographic parameters with invasive reference standards by high-fidelity micromanometer catheter. Circ Cardiovasc Imaging 7:491–501CrossRefPubMed Okumura K, Slorach C, Mroczek D, Dragulescu A, Mertens L, Redington AN, Friedberg MK (2014) Right ventricular diastolic performance in children with pulmonary arterial hypertension associated with congenital heart disease: correlation of echocardiographic parameters with invasive reference standards by high-fidelity micromanometer catheter. Circ Cardiovasc Imaging 7:491–501CrossRefPubMed
Metadaten
Titel
Utility of Echocardiography in the Assessment of Left Ventricular Diastolic Function and Restrictive Physiology in Children and Young Adults with Restrictive Cardiomyopathy: A Comparative Echocardiography-Catheterization Study
verfasst von
Thomas D. Ryan
Peace C. Madueme
John L. Jefferies
Erik C. Michelfelder
Jeffrey A. Towbin
Jessica G. Woo
Rashmi D. Sahay
Eileen C. King
Roberta Brown
Ryan A. Moore
Michelle A. Grenier
Bryan H. Goldstein
Publikationsdatum
23.11.2016
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 2/2017
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-016-1526-0

Weitere Artikel der Ausgabe 2/2017

Pediatric Cardiology 2/2017 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.