PATET ratio by Doppler echocardiography: noninvasive detection of pediatric pulmonary arterial hypertension

Abstract

Pulmonary artery acceleration time (PAT) and PAT: ejection time (PATET) ratio are echocardiographic measurements of pulmonary arterial hypertension (PAH). These non-invasive quantitative measurements are ideal to follow longitudinally through the clinical course of PAH, especially as it relates to need for and/or response to treatment. This review article focuses on the current literature of PATET measurement for infants and children as it relates to shortening of the PATET ratio in PAH. At the same time, further development of PATET as an outcome measure for PAH in pre-clinical models, particularly mice, such that the field can move forward to human clinical studies that are both safe and effective. Here we present what is known about PATET in infants and children and discuss what is known in pre-clinical models with particular emphasis on neonatal mouse models. In both animal models and human disease, PATET allows for longitudinal measurements in the same individual, leading to more precise determinations of disease/model progression and/or response to therapy.

Right ventricular cardiomyocyte expansion accompanies cardiac regeneration in newborn mice after large left ventricular infarcts

“…We postulated that postcapillary pulmonary arterial hypertension secondary to LV failure immediately after MI could likely be responsible for such prominent RV adaptation in P1 hearts (Figure 1C). With high-resolution echocardiographic assessment, as recently described for neonatal mice and human infants (23,24), pulmonary artery acceleration time (PAAT) and pulmonary artery ejection time (PAET) were measured at 1 dps to assess increases in pulmonary arterial pressure (Supplemental Figure 5, F and G). Both PAAT and the PAAT/ PAET ratio were significantly decreased in P1 MI mice compared with sham controls, consistent with an increase in pulmonary arterial pressure (Figure 8G and Supplemental Figure 5H).…”

“…Correct location of the sampling gate was assured in color Doppler imaging. PAAT was measured as the time from the onset of systolic pulmonary blood flow to the peak flow velocity, and PAET as the total time of systolic pulmonary blood flow (23,24). All echocardiographic data are summarized in Supplemental Table 1.…”