Evaluation of the myocardial performance index and tissue doppler imaging by comparison to near-simultaneous catheter measurements in pediatric cardiac transplant patients

Savage, Andrew; Hlavacek, Anthony M.; Ringewald, Jeremy M.; Shirali, Girish S

doi:10.1016/j.healun.2010.03.014

Cited by 26 publications

(27 citation statements)

References 25 publications

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“…Furthermore, the mitral and tricuspid E/E' \ 5.0 had 93 and 89% negative predictive value, respectively for rejection and were proposed to be useful noninvasive screening measures to exclude rejection. In contrast, a recent study comparing DTI with nearsimultaneous catheter derived measures showed that LV E/E' did not correlate with PCWP or cardiac index [18]. Due to the limited number of rejection episodes in this study, the predictive value of E/E' could not be assessed.…”

Section: Discussioncontrasting

confidence: 79%

Doppler tissue imaging and catheter-derived measures are not independent predictors of rejection in pediatric heart transplant recipients

Sachdeva

Malik

Seib

et al. 2010

Int J Cardiovasc Imaging

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The purpose of the study is to determine the association of Doppler tissue imaging (DTI) and catheter-derived measures with rejection in pediatric heart transplant (PHT) recipients and to determine any correlation between DTI and catheter-derived measurements. Sixty echocardiograms were prospectively performed in 37 PHT recipients at the time of surveillance cardiac biopsy. During right-heart cardiac catheterization, sequential pressures of the right heart and pulmonary capillary wedge pressures (PCWP) were measured. DTI was performed to obtain peak systolic (S'), early (E') and late (A') diastolic velocities (cm/s) at tricuspid annulus, septum and mitral annulus. Septal S' and tricuspid annular A' were associated with rejection, but had low sensitivity and specificity. Elevated lateral mitral E/E' did not predict rejection. The mean pulmonary capillary wedge pressure (PCWP) and cardiac index were similar in those with and without rejection. The lateral mitral and septal E/E' did not correlate with PCWP. Some DTI-derived measures were altered during rejection, but were not clinically useful predictors of rejection. Catheter-derived measures were not significantly altered during rejection and did not correlate with DTI-derived measures. None of these measures can replace the current practice of performing cardiac biopsy for surveillance of rejection.

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Section: Discussioncontrasting

confidence: 79%

Doppler tissue imaging and catheter-derived measures are not independent predictors of rejection in pediatric heart transplant recipients

Sachdeva

Malik

Seib

et al. 2010

Int J Cardiovasc Imaging

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show abstract

“…The difference between Doppler tissue values of the septal versus lateral mitral valve was also noted and may be a result of the fact that the right ventricle, which for anatomic reasons affects the medial tissue Doppler signal did not manifest the same correlations, relative to RVEDP, as found on the left side. The latter result contrasts with the findings by Savage and Goldberg [10, 17], although those studies were performed in pediatric patients following cardiac transplantation, representing a distinct population from this RCM cohort.…”

Section: Discussioncontrasting

confidence: 99%

“…Although cardiac catheterization is the gold standard for determination of diastolic parameters, TTE is the preferred method for serial assessment of adult RCM patients given its noninvasive nature [3–9]. Importantly, RCM pathophysiology observed in adult-onset disease may not be characteristic of pediatric and adolescent disease, as the etiologies of myocardial disease may differ between these groups [10–12]. In this prospective study, we sought to characterize the relationship between invasive and TTE-derived noninvasive measures of diastolic function in pediatric and young adult patients with RCM.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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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 (rs = 0.79) and indexed left atrial volume (rs = 0.49), demonstrated significant positive correlation, while mitral valve A (rs = −0.44), lateral e′ (rs = −0.61) and lateral a′ (rs = −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.

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“…Tissue Doppler image modalities regarding LV filling have been evaluated, but the utility of E/e 0 in HTx patients is debatable. Sundereswaran et al 20 showed significant correlation between E/e 0 and pulmonary capillary wedge pressure in adult HTx patients, whereas Savage et al 21 found no such correlation in pediatric HTx patients.…”

Section: Discussionmentioning

confidence: 96%

Evaluation of longitudinal myocardial deformation by 2-dimensional speckle-tracking echocardiography in heart transplant recipients: Relation to coronary allograft vasculopathy

Clemmensen¹,

Løgstrup²,

Eiskjær³

et al. 2015

The Journal of Heart and Lung Transplantation

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Evaluation of the myocardial performance index and tissue doppler imaging by comparison to near-simultaneous catheter measurements in pediatric cardiac transplant patients

Cited by 26 publications

References 25 publications

Doppler tissue imaging and catheter-derived measures are not independent predictors of rejection in pediatric heart transplant recipients

Doppler tissue imaging and catheter-derived measures are not independent predictors of rejection in pediatric heart transplant recipients

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

Evaluation of longitudinal myocardial deformation by 2-dimensional speckle-tracking echocardiography in heart transplant recipients: Relation to coronary allograft vasculopathy

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