Normal values of the pulmonary artery acceleration time (PAAT) and the right ventricular ejection time (RVET) in children and adolescents and the impact of the PAAT/RVET-index in the assessment of pulmonary hypertension

Habash, Sheeraz; Laser, Kai Thorsten; Moosmann, Julia; Reif, R; Adler, Werner; Glöckler, Martin; Kececioglu, Deniz; Dittrich, Sven

doi:10.1007/s10554-019-01540-w

Cited by 24 publications

(24 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Unlike previous studies in term and preterm infants, our results show that PAAT/RVET does not correlate with PA pressures measured on cardiac catheterization. However, our results show that PAAT, corrected for HR, does correlate with mPAP and sPAP.…”

Section: Discussioncontrasting

confidence: 99%

“…HR is >124 and >142, respectively. 26 In our study, the median heart rate was 146, above these cutoff values. Nearly half of the patients were mechanically ventilated prior to cardiac catheterization, which suggests a high severity of illness and could explain the higher heart rates.…”

Section: Hr and Paat As Well As Between Hr And Rvet Is Not Present Whenmentioning

confidence: 39%

“…Other studies have shown that PAAT/RVET poorly correlates with pulmonary artery pressures . A recently published study shows that the linear inverse relationship between HR and PAAT as well as between HR and RVET is not present when HR is >124 and >142, respectively . In our study, the median heart rate was 146, above these cutoff values.…”

Section: Discussionmentioning

confidence: 97%

“…We also showed that our PAAT/RVET ratios in preterm infants were significantly higher than those previously published by Levy et al 21 Our hypothesis is that the ratio of PAAT/RVET does not correlate with PA pressures because our patients have higher heart rates and therefore shorter RVETs compared to those in previous reports. 17,21,26 It is well established that there is an inverse relationship between PAAT and heart rate. 19,26 Some studies have corrected for heart rate using PAAT/RVET.…”

Section: Discussionmentioning

confidence: 99%

“…17,21,26 It is well established that there is an inverse relationship between PAAT and heart rate. 19,26 Some studies have corrected for heart rate using PAAT/RVET. 11,17,21,27 Other studies have shown that PAAT/RVET poorly correlates with pulmonary artery pressures.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Relationship between pulmonary artery acceleration time and pulmonary artery pressures in infants

et al. 2019

View full text Add to dashboard Cite

Background Pulmonary artery acceleration time measured by echocardiography inversely correlates with pulmonary artery pressures in adults and children older than 1 year of age. There is a paucity of data investigating this relationship in young children, particularly among preterm infants. Objective To characterize the relationship between pulmonary artery acceleration time (PAAT) and pulmonary artery pressures in infants. Design/Methods Patients ≤ 1 year of age at Children's Hospital of Philadelphia between 2011 and 2017 were reviewed. Infants with congenital heart disease were excluded, except those with a patent ductus arteriosus (PDA), atrial septal defect (ASD), or ventricular septal defect (VSD). Linear regression analysis was used to assess the correlation between PAAT measured by echocardiography and systolic pulmonary artery pressure, mean pulmonary artery pressure, and indexed pulmonary vascular resistance from cardiac catheterization. Results Fifty‐seven infants were included, of which 61% were preterm and 49% had a diagnosis of bronchopulmonary dysplasia. The median postmenstrual age and weight at catheterization were 51.1 weeks (IQR 35.8–67.9 weeks) and 4400 g (IQR 3100–6500 g), respectively. Forty‐four infants (77%) had a patent ductus arteriosus (PDA). There was a weak inverse correlation between PAAT with mPAP (r = −0.35, P = 0.01), sPAP (r = −0.29, P = 0.03), and PVRi (r = −0.29, P = 0.03). Conclusion There is a weak inverse relationship between PAAT and pulmonary artery pressures. This relationship is less robust in our population of infants with a high incidence of PDAs compared to previous studies in older children. Thus, PAAT may be less clinically meaningful for diagnosing pulmonary arterial hypertension in infants, particularly those with PDAs.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Hr and Paat As Well As Between Hr And Rvet Is Not Present Whenmentioning

confidence: 39%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Relationship between pulmonary artery acceleration time and pulmonary artery pressures in infants

et al. 2019

View full text Add to dashboard Cite

show abstract

Fetal Thoracic Circumference and Lung Volume and Their Relation to Fetal Size and Pulmonary Artery Blood Flow

Hilde

Carlsen

Bains

et al. 2021

J of Ultrasound Medicine

View full text Add to dashboard Cite

Objective Research on early origins of lung disease suggests the need for studying the relationships of thoracic and lung size with fetal size and pulmonary circulation. The primary aim of this study is therefore to explore the associations between fetal thoracic circumference, lung volume, and fetal size. We also aim to assess if lung volume and thoracic circumference are associated with fetal pulmonary artery blood flow velocity measures. Methods Cross‐sectional assessment of singleton pregnancies from the general population (n = 447) at 30 gestational weeks (GW) was performed using ultrasound measurement of fetal thoracic circumference, lung volume, head and abdominal circumference, and femur length. We obtained Doppler blood flow velocity measures from the proximal branches of the fetal pulmonary artery. Associations between variables were studied using Pearson's correlation and multiple linear regression analyses. Results Both thoracic circumference and lung volume correlated with fetal size measures, ranging from r = 0.64 between thoracic circumference and abdominal circumference, to r = 0.28 between lung volume and femur length. Adjustment for gestational age, maternal nicotine use, pre‐pregnancy body mass index, and fetal sex marginally influenced the associations with abdominal circumference. The correlations of thoracic circumference and lung volume with pulmonary artery blood flow velocity measures were weak (r ≤ 0.17). Conclusion We found moderate to low correlation between thoracic circumference, lung volume, and fetal size at 30 GW. The closest relationship was with the abdominal circumference. We found low correlations of thoracic circumference and lung volume with pulmonary artery blood flow velocity measures.

show abstract

Prostaglandin‐E1 infusion in persistent pulmonary hypertension of the newborn

Tsoi,

Nawaytou,

Almeneisi

et al. 2023

Pediatric Pulmonology

View full text Add to dashboard Cite

BackgroundNeonates with persistent pulmonary hypertension of the newborn (PPHN) can present with hypoxia and right ventricular dysfunction with resultant inadequate oxygen delivery and end‐organ damage. This study describes the use of prostaglandin‐E1 (PGE) for ductal patency to preserve right ventricular systolic function and limit afterload in newborns with PPHN.MethodsThis is a retrospective cohort study that follows the hemodynamics, markers of end‐organ perfusion, length of therapeutics, and echocardiographic variables of 57 newborns who used prostglandin‐E1 in the setting of PPHN.ResultsTachycardia, lactic acidosis, and supplemental oxygen use improved following PGE initiation. Fractional area change (FAC), to assess right ventricular systolic function, and pulmonary arterial acceleration time indexed to right ventricular ejection time (PAAT/RVET), to assess right ventricular afterload, also improved over three time points relative to PGE use (before, during, and after).ConclusionsOverall, we described the safety and utility of PGE in newborns with severe PPHN for stabilization while allowing natural disease progression.

show abstract

Normal values of the pulmonary artery acceleration time (PAAT) and the right ventricular ejection time (RVET) in children and adolescents and the impact of the PAAT/RVET-index in the assessment of pulmonary hypertension

Cited by 24 publications

References 30 publications

Relationship between pulmonary artery acceleration time and pulmonary artery pressures in infants

Relationship between pulmonary artery acceleration time and pulmonary artery pressures in infants

Fetal Thoracic Circumference and Lung Volume and Their Relation to Fetal Size and Pulmonary Artery Blood Flow

Prostaglandin‐E1 infusion in persistent pulmonary hypertension of the newborn

Contact Info

Product

Resources

About