Quantitative assessment of ventricular function in children with single ventricles using the Doppler myocardial performance index

Williams, Richard V.; Ritter, Saskia; Tani, Lloyd Y.; Pagotto, Luciana T.; Minich, L. LuAnn

doi:10.1016/s0002-9149(00)01168-1

Cited by 82 publications

(44 citation statements)

References 15 publications

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“…1) [13]. In the normal pediatric population, an MPI value of 0.32 ± 0.10 has previously been reported [23]. Higher MPI values indicate worsening combined systolic/ diastolic function.…”

Section: Cardiac Evaluationmentioning

confidence: 83%

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Cardiac abnormalities in children with sickle cell anemia

et al. 2002

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Sickle cell anemia (SCA) results in chronic volume overload of the heart due to hemodilution. Previous echocardiographic studies of cardiac function in children with SCA have not accounted for these abnormal loading conditions. The objectives of this study were to (1) determine how the degree of anemia and transfusion status relate to cardiac findings and (2) evaluate cardiac function using load-independent parameters of function. We evaluated 77 patients with SCA, ages 2 to 22 years (mean ± SD = 11.7 ± 4.7), using physical examination, electrocardiography, and echocardiography. We compared two groups of patients. Group 1 consisted of 57 non-transfused patients, and Group 2 consisted of 20 patients on a chronic transfusion protocol. Group 1 patients exhibited a significantly lower hemoglobin, higher cardiac output, and larger left ventricular (LV) end-diastolic dimension and LV mass than groups 2 (P < 0.05). However, the velocity of circumferential fiber shortening-wall stress index (a load-independent measure of systolic function) was normal and not statistically different between the two groups. Conversely, the LV myocardial performance index (a measure of combined systolic and diastolic function) was significantly higher in Group 2 (P < 0.001), possibly indicating impaired myocardial diastolic function. SCA in children results in a volume-overloaded heart with a significant increase in LV dimensions and mass, both proportional to the degree of anemia. Despite these abnormal loading conditions, systolic function is preserved. Patients on a chronic transfusion protocol may develop diastolic dysfunction despite iron chelation therapy. Am.

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“…1) [13]. In the normal pediatric population, an MPI value of 0.32 ± 0.10 has previously been reported [23]. Higher MPI values indicate worsening combined systolic/ diastolic function.…”

Section: Cardiac Evaluationmentioning

confidence: 83%

“…MPI is a combined measure of systolic and diastolic function. Higher MPI values have been found to correlate with worsening myocardial systolic and/or diastolic function [13,23]. LV MPI was significantly elevated in Group 2 patients when compared to the Group 1 patients.…”

Section: Clinical Findingsmentioning

confidence: 99%

Cardiac abnormalities in children with sickle cell anemia

et al. 2002

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“…205,206 The frequent presence of abnormal ventricular anatomy warrants the addition of a Doppler echocardiography-derived index of myocardial performance index (or Tei index) or measurement of blood levels of brain natriuretic peptide (BNP). [192][193][194]207,208 BNP production is affected by ventricular wall stress (eg, pressure overload such as AS, in which BNP appears to be influenced by both systolic and diastolic load). 209 BNP has been shown to be elevated not only in patients with heart failure and LV systolic dysfunction but also in patients with diastolic dysfunction and in RV dysfunction.…”

Section: Heart Failure In Adult Congenital Heart Diseasementioning

confidence: 99%

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease

Warnes¹,

Williams²,

Bashore³

et al. 2008

Circulation

892

365

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“…The index is (1) less dependent on HR and blood pressure; 9 (2) independent of the geometry of the ventricles, so it can be used to assess any type of ventricle; [10][11][12][13] and (3) an efficient quantitative assessment of the ventricle, which is ideal for comparing the relative ventricular performance before and after various types of interventions. 14,15 A striking disadvantage, however, is that the MPI may be affected by loading conditions.…”

Section: Mpimentioning

confidence: 99%

“…[9][10][11] The index has been used as a highly sensitive indicator of ventricular function in patients with various congenital heart defects measured as having uni-or biventricular physiology by transthoracic echocardiography. 12,13 The MPI has also been measured by intraoperative transesophageal echocardiography (ITEE) to evaluate various intraoperative interventions in patients undergoing open-heart surgery. 14,15 We hypothesized that an intraoperative real-time measurement of MPI might allow us to better demonstrate the effect of MUF on systemic ventricular function, so in this study, we divided the entire cohort into 5 subgroups: atrial septal defect (ASD), ventricular septal defect (VSD), tetralogy of Fallot (TOF), single left ventricle (SLV) and single right ventricle (SRV), with the aim of determining by means of the Doppler-derived MPI the diagnosis-based differences in the response of systemic ventricular performance to MUF in children undergoing open-heart surgery.…”

mentioning

confidence: 99%

Diagnosis-Based Differences in Response of Global Ventricular Performance to Modified Ultrafiltration in Children

Honjo

Osaki

Kotani

et al. 2010

Circ J

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Background: To determine diagnosis-based differences in the response of global ventricular performance to modified ultrafiltration (MUF) using transesophageal echocardiography during congenital heart surgery. Methods and Results:The study included 38 children with atrial septal defect (n=10), ventricular septal defect (VSD) (n=8), tetralogy of Fallot (TOF) (n=9), or a single ventricle (n=11). Arteriovenous MUF was performed for 10-15 min after cardiopulmonary bypass (CPB). The myocardial performance index (MPI) of the systemic ventricles and the % change in MPI before and after MUF were assessed. Impairment of MPI was noted at termination of CPB compared with baseline values in the VSD and TOF groups (P<0.05). MUF resulted in an improvement in MPI in all groups (P<0.01). There was a weak correlation between aortic cross-clamping or CPB time, and the degree of improvement in MPI (r=−0.385, P=0.019; r=−0.348, P=0.037, respectively). MUF improved fractional shortening in all groups (P<0.05) and reversed abnormal relaxation in the VSD and TOF groups. Conclusions:Modified ultrafiltration ameliorated MPI in all groups, indicating improved systemic ventricular function with MUF. The MPI recovery rate differed among the groups. MUF may be particularly useful for restoring the global ventricular performance of patients undergoing longer CPB and may have minimal advantages for simple open-heart surgery. (Circ J 2010; 74: 86 - 92)

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Quantitative assessment of ventricular function in children with single ventricles using the Doppler myocardial performance index

Cited by 82 publications

References 15 publications

Cardiac abnormalities in children with sickle cell anemia

Cardiac abnormalities in children with sickle cell anemia

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease

Diagnosis-Based Differences in Response of Global Ventricular Performance to Modified Ultrafiltration in Children

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