Left Ventricular Diastolic Mechanical Dyssynchrony and Associated Clinical Outcomes in Children With Dilated Cardiomyopathy

Friedberg, Mark K.; Roche, S. Lucy; Mohammed, Arshiya F.; Balasingam, M.; Atenafu, Eshetu G.; Kantor, Paul F.

doi:10.1161/circimaging.108.782086

Cited by 33 publications

(37 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We previously found that mechanical dyssynchrony effecting diastole was associated with poor outcomes in pediatric DCM. 26 Subsequent adult studies describing variations on this pattern analysis and using various terminology have shown strong CRT response predictive profiles. 9,17 Although a strong case is made for using strain pattern analysis to predict CRT response, CPD as a dichotomous analysis does not yet adequately differentiate the degree of mechanical dyssynchrony.…”

Section: Measuring Mechanical Dyssynchrony and Cpdmentioning

confidence: 99%

Classic-Pattern Dyssynchrony and Electrical Activation Delays in Pediatric Dilated Cardiomyopathy

Forsha

Slorach

Chen

et al. 2014

Journal of the American Society of Echocardiography

Self Cite

View full text Add to dashboard Cite

Section: Measuring Mechanical Dyssynchrony and Cpdmentioning

confidence: 99%

Classic-Pattern Dyssynchrony and Electrical Activation Delays in Pediatric Dilated Cardiomyopathy

Forsha

Slorach

Chen

et al. 2014

Journal of the American Society of Echocardiography

Self Cite

View full text Add to dashboard Cite

“…Moreover, there are very few studies investigating DD in childhood CM, and these involve relatively small numbers of patients. [1][2][3]12 Consequently, diagnosis and grading of DD in childhood CM remains poorly defined. The aim of this study was to define problems in classification of DD in children with CM using echocardiography and to assess whether published adult echo guidelines for classification and grading of DD are applicable to this population.…”

Section: Clinical Perspective On P 261mentioning

confidence: 99%

“…[1][2][3] Although left ventricular (LV) ejection fraction (EF) correlates with patient outcomes in adults and children, echo parameters of DD are most predictive of outcome in pediatric dilated CM (DCM), 1,2 noncompaction, 4 and hypertrophic CM (HCM). 3,5,6 Therefore, echo diagnosis and grading of DD in childhood CM is important.…”

mentioning

confidence: 99%

Interpretation of Left Ventricular Diastolic Dysfunction in Children With Cardiomyopathy by Echocardiography

Dragulescu

Mertens

Friedberg

2013

Circ: Cardiovascular Imaging

Self Cite

150

View full text Add to dashboard Cite

Background-Left ventricular diastolic dysfunction (DD) is a key determinant of outcomes in pediatric cardiomyopathy (CM), but remains very challenging to diagnose and classify. Adult paradigms and guidelines relating to DD are currently applied in children. However, it is unknown whether these are applicable to children with CM. We investigated the assessment of DD in children with CM using adult and pediatric echocardiographic criteria and tested whether recent adult guidelines are applicable to this population. Methods and Results-Three investigators independently classified diastolic function in 4 study groups: controls, dilated, hypertrophic, and restrictive CM . Agreement among investigators, failure to classify DD, and the reasons for diagnostic failure were determined. The usefulness of individual echo parameters to diagnose and classify DD was assessed. One hundred seventy-five children (aged 0-18 years) were studied. DD diagnostic criteria were discrepant in the majority of patients. Delayed relaxation was diagnosed in only 14% of hypertrophic CM patients and never in dilated CM and restrictive CM, with 50% of those patients having coexisting findings of elevated filling pressures. Many key parameters, such as mitral and pulmonary venous Doppler, were not informative. Agreement among investigators for grading of DD was poor (36% of CM patients). Conclusions-Assessment of DD in childhood CM seems inadequate using current guidelines. The large range of normal pediatric reference values allows diagnosis of DD in only a small proportion of patients. Key echo parameters to assess DF are not sufficiently discriminatory in this population, and discrepancies between criteria within individuals prevent further classification and result in poor interobserver agreement.

show abstract

“…Diastolic dyssynchrony is also impaired in patients with on-treatment hypertension or diabetes mellitus [3,4]. Diastolic dyssynchrony is associated with adverse clinical outcomes in patients with dilated cardiomyopathy [16]. Diastolic dyssynchrony improves in responders but not in nonresponders after cardiac resynchronization therapy (CRT) [15], resulting in reduction in morbidity and mortality [17].…”

Section: Introductionmentioning

confidence: 99%

Left ventricular diastolic dyssynchrony in patients with treatment-naive hypertension and the effects of antihypertensive therapy

Kwon

Lee

Park

et al. 2015

Journal of Hypertension

View full text Add to dashboard Cite

Diastolic dyssynchrony is not rare in treatment-naive hypertensive patients. Male sex, magnesium levels, night-time HR, and mitral E/A are independent determinants for the impaired diastolic dyssynchrony. Antihypertensive therapy reduces both the severity and prevalence of diastolic dyssynchrony in patients with impaired diastolic dyssynchrony. Daytime HR, magnesium levels, and indications of systolic or diastolic dysfunction are independent predictors for improvements in diastolic dyssynchrony. Thus, magnesium levels, HR, and diastolic dysfunction seem to have important implications for diastolic dyssynchrony in hypertensive patients, whereas left ventricular hypertrophy, office BPs, arterial stiffness, central BPs, and ABPM parameters do not.

show abstract

Left Ventricular Diastolic Mechanical Dyssynchrony and Associated Clinical Outcomes in Children With Dilated Cardiomyopathy

Abstract: Background-We investigated diastolic mechanical dyssynchrony and its relation to clinical status in pediatric dilated cardiomyopathy (DCM

Cited by 33 publications

References 29 publications

Classic-Pattern Dyssynchrony and Electrical Activation Delays in Pediatric Dilated Cardiomyopathy

Classic-Pattern Dyssynchrony and Electrical Activation Delays in Pediatric Dilated Cardiomyopathy

Interpretation of Left Ventricular Diastolic Dysfunction in Children With Cardiomyopathy by Echocardiography

Left ventricular diastolic dyssynchrony in patients with treatment-naive hypertension and the effects of antihypertensive therapy

Contact Info

Product

Resources

About