Heart Failure with Preserved Ejection Fraction in Children

Das, Bibhuti B.; Deshpande, Shriprasad; Akam‐Venkata, Jyothsna; Shakti, Divya; Moskowitz, William B.; Lipshultz, Steven E.

doi:10.1007/s00246-022-02960-7

Cited by 12 publications

(6 citation statements)

References 191 publications

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“…We found that adding more ultrasound parameters to a multi‐parameter algorithm to grade diastolic function led to a higher diagnostic accuracy. In particular, LAS R performed well, as has been found in adults and children 2,37,38 . We did not have catheter pressure measurements as gold standard, hence it remains uncertain which multi‐parameter approach is best.…”

Section: Discussionmentioning

confidence: 63%

“…In particular, LAS R performed well, as has been found in adults and children. 2,37,38 We did not have catheter pressure measurements as gold standard, hence it remains uncertain which multi-parameter approach is best. Assuming the proportion of infants with high LAP (14%) is the target, and with improved sensitivity, we would recommend adding LAS R and define diastolic dysfunction when three or more out of the five parameters are abnormal.…”

Section: Discussionmentioning

confidence: 99%

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Echocardiography algorithms to assess high left atrial pressure and grade diastolic function in preterm infants

de Waal,

Phad,

Crendal

2023

Echocardiography

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BackgroundRelaxation, restoring forces, myocardial stiffness and atrial function determine left ventricular (LV) diastolic function. This study aims to provide a comprehensive assessment of diastolic function in preterm infants using conventional echocardiography and speckle tracking imaging and determine the diagnostic accuracy of various algorithms to detect high left atrial pressure (LAP).MethodsPreterm infants received an echocardiogram 1 week after birth and diastolic reference values were derived from the outer percentiles of stable preterm infants. Impaired relaxation, LV stiffness and high LAP were defined by using algorithms where at least half of the parameters were outside the normal range. Diastolic function was graded using the 2016 American Society of Echocardiography algorithm and expanded with the EA ratio and left atrial strain. The diagnostic accuracy of various algorithms to detect high LAP was determined with sensitivity analysis.ResultsWe studied 146 infants (59 stable) with a mean of 27(1) weeks gestation. Impaired relaxation, LV stiffness and high LAP were found in 8%, 7%, and 14% of infants. The patent ductus arteriosus was a contributing factor to high LAP and LV stiffness, not impaired relaxation. Diagnostic accuracy improved from 90% to 96% and sensitivity from 40% to 90% by adding left atrial strain to the 2016 algorithm.ConclusionVarious grades of diastolic dysfunction could be appreciated in preterm infants using a multi‐parameter approach. Adding left atrial strain improved sensitivity to detect infants with high LAP.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Echocardiography algorithms to assess high left atrial pressure and grade diastolic function in preterm infants

de Waal,

Phad,

Crendal

2023

Echocardiography

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“…In this instance, MRI was also used to demonstrate impaired aortic distensibility among the cohort. Most research to date is consistent with diastolic dysfunction, or heart failure with preserved ejection fraction, being more common in CKD [58]. This concept translates to childhood hypertension when subclinical differences in systolic and diastolic function can be detected among children with BP ≥80th percentile [59].…”

Section: Early Cardiovascular Phenotypesmentioning

confidence: 88%

Hypertension and Cardiovascular Risk Among Children with Chronic Kidney Disease

Larkins,

Craig

2024

Curr Hypertens Rep

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Purpose of Review Cardiovascular disease is the most common cause of mortality across the lifespan of children with chronic kidney disease (CKD). Hypertension is a common and important contributor, but other factors such as obesity, dyslipidemia and mineral bone disease play a role. This narrative review focusses on studies published in the past five years that have investigated hypertension and cardiovascular risk among children with CKD. Recent Findings Cohort studies such as Chronic Kidney Disease in Children (CKiD) and Cardiovascular Comorbidity in Children with CKD (4C) have continued to develop our understanding of blood pressure (BP) phenotypes, and of progressive changes in the structure and function of the heart and blood vessels occurring in children with CKD. Metabolic risk factors, such as dyslipidemia, may represent an under-recognized component of care. Trial data are less common than observational evidence, but support lifestyle interventions currently used, mainly the low sodium dietary approaches to stop hypertension (DASH) diet. The findings of the recently reported Hypertension Optimal Treatment in Children with Chronic Kidney Disease trial (HOT-KID) are described in relation to the use of office BP treatment targets. Summary Cardiovascular health is critical to the long-term outcomes of children with CKD. Recognizing and treating hypertension remains a critical component to improving outcomes, along with measures to improve concurrent cardiovascular risk factors. Some cardiovascular changes may not be reversible with transplantation and further research is needed for children at all stages of CKD.

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“…LV diastolic dysfunction (LVDD), defined as impaired relaxation and potentially accompanied by reduced restoring forces, early diastolic suction [19], and increased chamber stiffness [20,21], leads to symptomatic HF by causing elevated filling pressures at rest or with exertion [22]. LVP and LAP interact significantly in patients with LVDD.…”

Section: Abnormal LV Filling Patternsmentioning

confidence: 99%

Interpreting Diastolic Dynamics and Evaluation Through Echocardiography

Zhang,

Li,

Cardoso

et al. 2024

Preprint

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In patients with heart failure, the evaluation of left ventricular (LV) diastolic function is vital, offering crucial insights into hemodynamic impact and prognostic accuracy. Echocardiography stands as the primary imaging modality for diastolic function assessment, and using it effectively requires a profound understanding of the underlying pathology. This review covers four main topics: first, the fundamental driving forces behind each phase of normal diastolic dynamics, along with the physiological basis of two widely used echocardiographic assessment parameters, E/e' and mitral annulus early diastolic velocity (e'); second, the intricate functional relationship between the left atrium and LV in patients with varying degrees of LV diastolic dysfunction (LVDD); third, the role of stress echocardiography in diagnosing LVDD and the significance of parameter changes in this context; and fourth, the clinical utility of evaluating diastolic function from echocardiography images across diverse cardiovascular care areas.

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Heart Failure with Preserved Ejection Fraction in Children

Cited by 12 publications

References 191 publications

Echocardiography algorithms to assess high left atrial pressure and grade diastolic function in preterm infants

Echocardiography algorithms to assess high left atrial pressure and grade diastolic function in preterm infants

Hypertension and Cardiovascular Risk Among Children with Chronic Kidney Disease

Interpreting Diastolic Dynamics and Evaluation Through Echocardiography

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