Tissue Doppler Measurements Correlate With Central Venous Pressure in Pediatric Patients After Cardiac Surgery

Abstract

Tissue Doppler imaging (TDI) measurements have been demonstrated to correlate with central venous pressure (CVP) in adults. We hypothesize that TDI measurements also correlate with CVP in children after cardiac surgery. Patients younger than 10 years with invasive CVP monitoring after cardiac surgery were studied. Annular tissue and atrioventricular inflow velocities were measured daily during CVP monitoring. Tissue Doppler imaging measurements were compared with CVP by univariate analyses. Subgroup analyses were performed for univentricular versus biventricular hearts. p values < or = 0.05 were considered significant. Fifty studies were performed on 28 subjects; 20 studies were performed on patients with univentricular physiology; and 30 studies were performed on patients with biventricular physiology. For all subjects, CVP correlated significantly with the right ventricular TDI measurements of e' velocity (r = -0.43), a' velocity (r = 0.35), e'/a' ratio (r = -0.42), and E/e' ratio (r = 0.44). For biventricular patients, e' velocity (r = -0.35), e'/a' ratio (r = -0.38), and E/e' ratio (r = 0.58) correlated significantly. For univentricular patients, E velocity (r = -0.62), e' velocity (r = -0.50), and a' (r = 0.61) velocity correlated significantly. Tissue Doppler imaging measurements of the right heart significantly correlated with invasively measured CVP in pediatric subjects. Different measures may correlate more strongly in those with biventricular versus univentricular physiology. With additional study, TDI may prove a valid tool for noninvasively assessing CVP in children with both bi- and univentricular physiology.

Tissue Doppler–Derived Strain and Strain Rate during the First 28 Days of Life in Very Low Birth Weight Infants

“…Early assessment of RV dysfunction or elevated pulmonary pressure could greatly benefit the care for critically ill newborns. Other studies have already shown promising results indicating that TDI might deliver new opportunities for assessing right ventricular function . Although we were not able to completely attribute the decrease in RV free wall PSS to the development of BPD, we could show a change in RV free wall PSS in groups with BPD on day 14.…”

“…Other studies have already shown promising results indicating that TDI might deliver new opportunities for assessing right ventricular function. [39][40][41] Although we were not able to completely attribute the decrease in RV free wall PSS to the development of BPD, we could show a change in RV free wall PSS in groups with BPD on day 14. At this age, there was no difference in RV free wall PSS when examining the effect of MV.…”

Systolic/diastolic ratio correlates with end diastolic pressures in pediatric patients with single right ventricles

“…Evaluating diastolic function in patients with single ventricle physiology noninvasively is usually subjective despite the fact that diastolic dysfunction may be associated morbidity and mortality in this complex patient population. [1][2][3][4]15,16 Previous studies have shown mixed results with correlating echocardiographic values with catheterization VEDP. [5][6][7][8]10 In this study, S/D ratio correlated significantly with catheter derived VEDP in patients with single RV physiology.…”

Survey of How Pediatric Cardiologists Noninvasively Evaluate Patients with Hypoplastic Left Heart Syndrome

“…Preliminary studies have shown modest correlation between TDI values and end diastolic pressures measured invasively in patients with single ventricle physiology. 28,29 However, approximately 30% of respondents graded diastolic function qualitatively. One has to assume that if qualitative grading of systolic function was less than ideal, 27 qualitative diastolic grading would be beset with even more inconsistencies.…”

“…More data need to be obtained, but initial studies at least appear to indicate that TDI and deformation analysis hold promise as a measurement for diastolic function in this population. [28][29][30] TDI measurement was the method that respondents would follow most often longitudinally to assess for diastolic function. This may be due to the ease in obtaining these values, its reproducibility, and the data in adults supporting this measurement as valid.…”