Doppler tissue imaging provides an estimate of pulmonary arterial pressure in children with pulmonary hypertension due to congenital intracardiac shunts

Congenit Heart Dis. Nov-Dec 2013;8(6):527-34. doi: 10.1111/chd.12030. Epub 2012 Dec 27.

Abstract

Objective: The aim of this study is to determine the relationship between the cardiac catheterization findings and pulsed-wave (PW) Doppler and Doppler tissue imaging (DTI) in pulmonary arterial hypertension patients with congenital heart disease with intracardiac shunts.

Design and patients: The present study aims to determine the relationship between the cardiac catheterization findings and PW Doppler and Doppler tissue imaging (DTI) in patients who have pulmonary arterial hypertension patients due to congenital heart disease with intracardiac shunts. Echocardiographic measurements were performed at the catheter angiography laboratory with concurrent catheterization. Left and right ventricle inflow velocities were recorded with PW Doppler and DTI studies. Maximum tricuspid regurgitation velocity (TS) was recorded in cases with measurable levels by continuous-wave Doppler. Moreover, the correlations among the echocardiographic values and invasive hemodynamic measures such as systolic pulmonary arterial pressure (PAPsystolic), mean pulmonary arterial pressure (PAPmean), diastolic pulmonary arterial pressure (PAPdiastolic) and pulmonary vascular resistance index (PVRI) were evaluated.

Results: A negative correlation was found between TE'/TA' and PAPsystolic, PAPdiastolic and PAPmean (P = 0.008, r = -0.480; P = 0.001, r = -0.584; P = 0.001, r = -0.567, respectively). ME/ME' was also found to be negatively correlated with PAPdiastolic, PAPmean and PVRI (P = 0.002, r = -0.556; P = 0.005, r = -0.502; P = 0.027, r = -0.411, respectively). The concurrent use of TE'/TA' (cut-off value <2.6) and TS had a sensitivity of 79% and a specificity of 93% for distinguishing between patients with healthy controls.

Conclusion: When used in conjunction with conventional methods, TE'/TA' has the highest sensitivity and specificity in distinguishing between patients and healthy controls.

Keywords: Congenital Heart Disease; Doppler Tissue Imaging; Intracardiac Shunt; Pulmonary Arterial Hypertension.

MeSH terms

  • Age Factors
  • Arterial Pressure*
  • Blood Pressure Determination / methods*
  • Cardiac Catheterization
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Coronary Circulation*
  • Echocardiography, Doppler*
  • Familial Primary Pulmonary Hypertension
  • Female
  • Heart Defects, Congenital / complications*
  • Heart Defects, Congenital / physiopathology
  • Humans
  • Hypertension, Pulmonary / diagnostic imaging*
  • Hypertension, Pulmonary / etiology
  • Hypertension, Pulmonary / physiopathology
  • Infant
  • Male
  • Predictive Value of Tests
  • Pulmonary Artery / diagnostic imaging*
  • Pulmonary Artery / physiopathology
  • Pulmonary Circulation*
  • Vascular Resistance
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Right / diagnostic imaging
  • Ventricular Dysfunction, Right / etiology
  • Ventricular Dysfunction, Right / physiopathology
  • Ventricular Function, Left
  • Ventricular Function, Right