Function Heterogeneity of Different Segments of Left Ventricle in Pediatric Dilated Cardiomyopathy: A Tissue Doppler Study

Abstract

Background: Dilated cardiomyopathy (DCM) is characterized by impaired systolic and diastolic function of one or both ventricles. Aim of the Work:To assess left ventricular (LV) regional systolic as well as global systolic, diastolic functions and desynchrony in children with idiopathic DCM using tissue Doppler imaging. Materials and Methods:The study comprised 30 patients with idiopathic DCM (4.4+3.3 years) and 10 healthy children as a control group. Electrocardiography (ECG)-gated echocardiography was done using m-mode and conventional Doppler as well as tissue Doppler imaging to obtain modified Tei index, mitral annular wave velocities (S', E' and A') as well as offline analysis of color tissue velocity imaging to obtain the peak systolic velocities of 12 LV points in apical four chamber, two chamber and long axis views. Results:The peak systolic velocities of mitral annulus as well as the different LV segments of patients were significantly lower than that of the control group. The E/E' ratio of patients was (11.39+2.4). S' and E' wave of lateral and septal aspects of mitral annulus were correlated. The Tei index of LV of patients (0.568+0.1136) was significantly higher than that of the control group. The averaged mid LV segments showed significantly lower peak systolic velocity (3.018+0.777cm/sec). There was significant difference between different LV segments as regards the peak systolic velocities (P<0.05). When comparing the time to peak standard deviation (TP-SD) of lateral wall (±36.071) to septal wall (±33.020), no marked difference was detected (P>0.05). Conclusion:The diastolic dysfunction among children with idiopathic DCM lies in the borderline zone. Systolic and diastolic dysfunctions correlate. There is regional heterogeneity of left ventricular systolic velocities being in general lower in mid segments. No marked left ventricular systolic desynchrony in DCM was found in pediatric age group.

Validity of Clinical Indications of Pediatric Bedside Echocardiography in Critically Ill Children: A Single Center Study

“…Echocardiography is a valuable tool that has become a standard service in neonatal and pediatric intensive care units to provide prompt timely assessment of cardiac structure and function, follow up of medications and guide intervention (10). Bedside echocardiography is increasingly being relied upon as an extension of physical examination, and in conjunction with the existing clinical parameters in making clinical decisions (11,12).…”

Euthyroid State in Hashimoto Thyroiditis in Children Seems to Protect Against Subclinical Cardiomyopathy

“…Examination was performed in the left lateral semi-recumbent or the supine position in a resting quiet breathing condition. The measurements of the M-mode were done at the level of the tips of mitral valve leaflets in the parasternal long-axis view of the left ventricle (LV), as left ventricular end-systolic diameter (LVESd), left ventricular end-diastolic diameter (LVEDd), interventricular septum thickness (IVST) and LV posterior wall thickness (LVPWT), and ejection fraction (EF) (11).…”