Pre‐ and Postoperative Quantitation of Right Ventricular Tissue Doppler Velocities in Infants with Hypoplastic Left Heart Syndrome

Christensen, Douglas D; Cardis, Brian M.; Mahle, William T.; Lewis, Reginald; Huckaby, Jeryl; Favaloro-Sabatier, Jennifer; Fyfe, Derek A.

doi:10.1111/j.1540-8175.2006.00207.x

Cited by 11 publications

(3 citation statements)

References 17 publications

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“…Simple echocardiographic methods were measured and newer modalities such as 3-dimensional echocardiography, tissue Doppler imaging, strain, or strain rate analysis may have been more powerful in predicting clinical variables. [21][22][23] In conclusion, PDA VTI measurements and RV percentage change correlated with some peri-operative comprehensive Stage II clinical variables, but no echocardiographic variable predicted major clinical outcomes. A larger patient population and new imaging modalities may be useful in better predicting clinical outcomes in this select group of patients.…”

Section: Discussionmentioning

confidence: 82%

“…Color images were used to measure PDA diameter and thus cardiac outputs may have been systematically overestimated, but these measurements were more reproducible than the 2D images secondary to stent artifact that sometimes obscured the area of interest. Simple echocardiographic methods were measured and newer modalities such as 3‐dimensional echocardiography, tissue Doppler imaging, strain, or strain rate analysis may have been more powerful in predicting clinical variables 21–23 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Echocardiographic Parameters that Predict Outcome in Aortic Atresia Patients Undergoing Comprehensive Stage II Procedure

Birnbaum¹,

Berger

Fenstermaker

et al. 2010

Congenital Heart Disease

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Echocardiographic Parameters that Predict Outcome in Aortic Atresia Patients Undergoing Comprehensive Stage II Procedure

Birnbaum¹,

Berger

Fenstermaker

et al. 2010

Congenital Heart Disease

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“…Hughes 10 identified better early post-operative RV systolic function after RVPAS compared to MBTS, while others found either no difference between shunt groups 11,12 or decreased RV function early after RVPAS. 13 The few studies using more innovative echocardiographic techniques to assess RV function after the Norwood procedure, including dP/dt from the TR jet, 14 tricuspid annular DTI, 11,15 indices of diastolic function, 11 and the MPI 11 have also been limited by small sample size at a single center. In contrast, this study is the first multi-center trial specifically designed to compare echocardiographic indices in a large cohort of patients randomized to receive either a RVPAS or MBTS at initial palliation.…”

Section: Discussionmentioning

confidence: 99%

Does Initial Shunt Type for the Norwood Procedure Affect Echocardiographic Measures of Cardiac Size and Function During Infancy?

et al. 2012

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Background The Pediatric Heart Network trial comparing outcomes in 549 infants with single right ventricle (RV) undergoing a Norwood procedure randomized to modified Blalock-Taussig shunt (MBTS) or right ventricle-to-pulmonary artery shunt (RVPAS) found better one-year transplant-free survival in those who received RVPAS. We sought to compare the impact of shunt type on echocardiographic indices of cardiac size and function up to 14 months of age. Methods and Results A core laboratory measured indices of cardiac size and function from protocol exams: early after Norwood (age 22.5±13.4 days), before stage II procedure (age 4.8±1.8 months) and at 14 months (age 14.3±1.2 months). Mean RV ejection fraction was <50% at all intervals for both groups and was higher in the RVPAS group post-Norwood (49±7 vs. 44±8%, P<0.001), but was similar by 14 months. Tricuspid and neo-aortic regurgitation, diastolic function, and pulmonary artery and arch dimensions were similar in the two groups at all intervals. Neo-aortic annulus area (4.2±1.2 vs. 4.9±1.2 cm2/m2), systolic ejection times (214.0±29.4 vs. 231.3±28.6 msec), neo-aortic flow (6.2±2.4 vs. 9.4±3.4 L/min/m2), and peak arch velocity (1.9±0.7 vs. 2.2±0.7 m/sec) were lower at both interstage exams in RVPAS compared to MBTS (P<0.001 for all), but all were similar at 14 months. Conclusion Indices of cardiac size and function after the Norwood procedure are similar for MBTS and RVPAS by 14 months of age. Interstage differences between shunt types can likely be explained by the physiology created when the shunts are in place rather than by intrinsic differences in cardiac function. Clinical Trial Registration # NCT00115934, URL: http://clinicaltrials.gov/ct2/show/NCT00115934

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Assessment of Ventricular Function and Dyssynchrony Before and After Stage 2 Palliation of Hypoplastic Left Heart Syndrome Using Two-Dimensional Speckle Tracking

et al. 2010

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Two-dimensional (2D) speckle tracking (2DST) is a new technique independent of ventricular geometry but not independent of preload and afterload. Using 2DST, this study aimed to investigate differences in right ventricular (RV) function and intraventricular dyssynchrony in patients with hypoplastic left heart syndrome (HLHS) before and after preload-reducing stage 2 palliation. For 31 HLHS patients, this study compared global longitudinal strain (S) and strain rate (SR) as well as regional peak systolic longitudinal S, SR, and velocity (V) in six RV segments on echocardiograms before and after stage 2 surgery. Intraventricular dyssynchrony was assessed by calculating the standard deviation of the intervals from the beginning of systole to peak S, SR, and V. Global S (-16.7 ± 5.0 vs -15.6 ± 5.5%) and global SR (-1.2 ± 0.3 vs -1.2 ± 0.3 s(-1)) did not change after surgery. After surgery, V decreased in the mid lateral segment (2.3 ± 1.3 vs 1.7 ± 0.9 cm/s; p = 0.01) and the basal lateral segment (3.6 ± 1.1 vs 2.8 ± 1.0 cm/s; p = 0.001), whereas S was lower in both of these segments (-19.9% ± 6.0% vs -17.4% ± 6.3%; p = 0.01 and 20.0 ± 5.1 vs 15.8 ± 7.1%; p = 0.002, respectively). Segmental SR and dyssynchrony did not change. Decreased V and S in the RV free wall could be explained by reduced preload of the systemic RV after stage 2 palliation.

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Pre‐ and Postoperative Quantitation of Right Ventricular Tissue Doppler Velocities in Infants with Hypoplastic Left Heart Syndrome

Cited by 11 publications

References 17 publications

Echocardiographic Parameters that Predict Outcome in Aortic Atresia Patients Undergoing Comprehensive Stage II Procedure

Echocardiographic Parameters that Predict Outcome in Aortic Atresia Patients Undergoing Comprehensive Stage II Procedure

Does Initial Shunt Type for the Norwood Procedure Affect Echocardiographic Measures of Cardiac Size and Function During Infancy?

Assessment of Ventricular Function and Dyssynchrony Before and After Stage 2 Palliation of Hypoplastic Left Heart Syndrome Using Two-Dimensional Speckle Tracking

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