Ezon David S, Maskatia Shiraz A, Sexson-Tejtel Kristen, Dreyer William J, Jeewa Aamir, Denfield Susan W
Section of Pediatric Cardiology, Baylor College of Medicine, Texas Children's Hospital, Houston, Tex, USA.
Congenit Heart Dis. 2015 Sep-Oct;10(5):E203-9. doi: 10.1111/chd.12267. Epub 2015 May 6.
In adults with cardiomyopathy, tissue Doppler imaging (TDI) has been shown to correlate with left ventricular filling pressures (LVFPs) and has been advocated as a surrogate to catheterization. However, this has not been validated in children.
This is a retrospective review of children ≤18 years old with dilated, hypertrophic, restrictive, and left ventricular noncompaction cardiomyopathy who underwent cardiac catheterization within 3 months of an echocardiogram. Spearman's correlation coefficients were calculated to assess a correlation between LVFP and mitral inflow E/A ratio, lateral mitral E/E', and septal E/E'.
Thirty-eight patients were included in the study; median age was 8.6 years old. The median LVFP was 19 mm Hg, median mean pulmonary artery pressure was 25 mm Hg, and median pulmonary vascular resistance index (PVRi) was 2.4 Wu. There was no significant correlation between LVFP or PVRi with lateral mitral E/E' or septal E/E'. There was a positive correlation between LVFP and mitral inflow E/A ratio (rs = 0.59, P < .01). In a subgroup analysis of patients with hypertrophic or restrictive cardiomyopathy, there was a negative correlation (rs = 0.56, P = .02) between the mean pulmonary artery pressure and septal A'.
TDI measures of diastolic function are not reliable surrogates for LVFP, mean pulmonary artery pressures, and PVRi at catheterization in children.
在成年心肌病患者中，组织多普勒成像（TDI）已被证明与左心室充盈压（LVFP）相关，并被提倡作为心导管检查的替代方法。然而，这在儿童中尚未得到验证。
这是一项对年龄≤18岁的扩张型、肥厚型、限制型和左心室致密化不全型心肌病患儿的回顾性研究，这些患儿在超声心动图检查后3个月内接受了心导管检查。计算Spearman相关系数以评估LVFP与二尖瓣流入E/A比值、二尖瓣外侧E/E'以及室间隔E/E'之间的相关性。
38例患者纳入研究；中位年龄为8.6岁。中位LVFP为19 mmHg，中位平均肺动脉压为25 mmHg，中位肺血管阻力指数（PVRi）为2.4 Wood单位。LVFP或PVRi与二尖瓣外侧E/E'或室间隔E/E'之间无显著相关性。LVFP与二尖瓣流入E/A比值呈正相关（rs = 0.59，P < 0.01）。在肥厚型或限制型心肌病患者的亚组分析中，平均肺动脉压与室间隔A'呈负相关（rs = 0.56，P = 0.02）。
在儿童心导管检查中，TDI舒张功能测量值并非LVFP、平均肺动脉压和PVRi的可靠替代指标。
