1. Validation of Noninvasive Measures of Left Ventricular Mechanics in Children: A Simultaneous Echocardiographic and Conductance Catheterization Study
- Author
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Anthony M. Hlavacek, Varsha M. Bandisode, Carolyn L. Taylor, Ryan J. Butts, Karen S. Chessa, Girish S Shirali, G. Hamilton Baker, and Shahryar M. Chowdhury
- Subjects
Male ,Cardiac Catheterization ,medicine.medical_specialty ,Heart Ventricles ,Left heart catheterization ,030204 cardiovascular system & hematology ,Sensitivity and Specificity ,Ventricular Function, Left ,Article ,Contractility ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Ductus arteriosus ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Child ,Ventricular mechanics ,business.industry ,Reproducibility of Results ,Blood Pressure Determination ,Stroke Volume ,Mean age ,Left ventricular contractility ,Myocardial Contraction ,medicine.anatomical_structure ,Blood pressure ,Echocardiography ,Balloon occlusion ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
The accuracy of echocardiography in evaluating left ventricular contractility has not been validated in children. The objective of this study was to compare echocardiographic measures of contractility with those derived from pressure-volume loop (PVL) analysis in children.Patients with relatively normal loading conditions undergoing routine left heart catheterization were prospectively enrolled. PVLs were obtained via conductance catheters. The gold-standard measure of contractility, end-systolic elastance (Ees), was obtained via balloon occlusion of one or both vena cavae. Echocardiograms were performed immediately after PVL analysis under the same anesthetic conditions. Single-beat estimations of echocardiographic Ees were calculated using four different methods. These estimates were calculated using a combination of noninvasive blood pressure readings, ventricular volumes derived from three-dimensional echocardiography, and Doppler time intervals.Of 24 patients, 18 patients were heart transplant recipients, and six patients had small patent ductus arteriosus or small coronary fistulae. The mean age was 9.1 ± 5.6 years. The average invasive Ees was 3.04 ± 1.65 mm Hg/mL. Invasive Ees correlated best with echocardiographic Ees by the method of Tanoue (r = 0.85, P .01), with a mean difference of -0.07 mm Hg/mL (95% limits of agreement, -2.0 to 1.4 mm Hg/mL).Echocardiographic estimates of Ees correlate well with gold-standard measures obtained via conductance catheters in children with relatively normal loading conditions. The use of these noninvasive measures in accurately assessing left ventricular contractility appears promising and merits further study in children.
- Published
- 2016
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