Comparison of Pressure-Volume Loop and Echocardiographic Measures of Diastolic Function in Patients With a Single-Ventricle Physiology

作者：Chowdhury Shahryar M^*; Butts Ryan J; Buckley Jason; Hlavacek Anthony M; Hsia Tain Yen; Khambadkone Sachin; Baker G Hamilton

来源：Pediatric Cardiology, 2014, 35(6): 998-1006.

DOI：10.1007/s00246-014-0888-4

• Pressure-volume loop
• Single ventricle
• Echocardiography
• Diastolic function

Echocardiographic measurements of diastolic function have not been validated against invasive pressure-volume loop (PVL) analysis in the single-ventricle population. The authors hypothesized that echocardiographic measures of diastolic function would correlate with PVL indices of diastolic function in patients with a single-ventricle physiology. The conductance-derived PVL measures of diastolic function included the isovolumic relaxation time constant (tau), the maximum rate of ventricular pressure decline (peak -dP/dt), and a measure of passive diastolic stiffness (mu). The echocardiographic measures included Doppler inflow patterns of the dominant atrioventricular valve (DAVV), tissue Doppler velocities (TDI) at the lateral (ventricular free wall) component of the DAVV annulus, and the TDI-derived isovolumic relaxation time (IVRT%26apos;). The correlation between PVL and echocardiographic measures was examined. The study enrolled 13 patients at various stages of surgical palliation. The median age of the patients was 3 years (range 3 months to 19 years). tau correlated well with Doppler E:A (r = 0.832; p = 0.005), lateral E:E%26apos; (r = 0.747; p = 0.033), and IVRT%26apos; (r = 0.831; p = 0.001). Peak -dP/dt also was correlated with IVRT%26apos; (r = 0.609; p = 0.036), and mu also was correlated with IVRT%26apos; (r = 0.884; p = 0.001). This study represents the first-ever comparison of diastolic echocardiographic and PVL indices in a single-ventricle population. The findings show that Doppler E:A, lateral E:E%26apos;, and IVRT%26apos; correlate well with PVL measures of diastolic function. This study supports further validation of echocardiographic measures of diastolic function versus PVL measures of diastolic function in the single-ventricle population.

• 出版日期2014-8