Tricuspid Annular Peak Systolic Velocity (S′) in Children and Young Adults with Pulmonary Artery Hypertension Secondary to Congenital Heart Diseases, and in Those with Repaired Tetralogy of Fallot: Echocardiography and MRI Data

Koestenberger, Martin; Nagel, Bert; Ravekes, William; Avian, Alexander; Heinzl, Bernd; Fandl, Andrea; Rehak, Thomas; Sorantin, Erich; Cvirn, Gerhard; Gamillscheg, Andreas

doi:10.1016/j.echo.2012.06.004

Cited by 56 publications

(44 citation statements)

References 35 publications

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“…85 In children with PH-CHD, the tricuspid annular S′ has been shown to be significantly impaired. 80 RV TDI parameters such as S′ correlate well with invasive pulmonary hemodynamics in pediatric PH-CHD patients and may therefore be useful for follow-up of these patients. 86 TDI velocities may also be useful markers of midterm outcomes in children with iPH.…”

Section: Tissue Doppler Velocitiesmentioning

confidence: 99%

“…78 Normal pediatric TDI data have been published. [79][80][81] Tissue velocities vary with age and heart rate and correlate with cardiac growth; 82 therefore, tissue velocities are not independent of geometry-which has important implications in children with CHD, who have variable RV size, mass, and geometry. In healthy neonates born at or near term, the longitudinal systolic tricuspid annular peak velocity (S′) was only 1.2 times the mitral annular velocity.…”

Section: Tissue Doppler Velocitiesmentioning

confidence: 99%

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Transthoracic Echocardiography in the Evaluation of Pediatric Pulmonary Hypertension and Ventricular Dysfunction

et al. 2016

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Transthoracic echocardiography (TTE) is the most accessible noninvasive diagnostic procedure for the initial assessment of pediatric pulmonary hypertension (PH). This review focuses on principles and use of TTE to determine morphologic and functional parameters that are also useful for follow-up investigations in pediatric PH patients. A basic echocardiographic study of a patient with PH commonly includes the hemodynamic calculation of the systolic pulmonary artery pressure (PAP), the mean and diastolic PAP, the pulmonary artery acceleration time, and the presence of a pericardial effusion. A more detailed TTE investigation of the right ventricle (RV) includes assessment of its size and function. RV function can be evaluated by RV longitudinal systolic performance (e.g., tricuspid annular plane systolic excursion), the tricuspid regurgitation velocity/right ventricular outflow tract velocity time integral ratio, the fractional area change, tissue Doppler imaging-derived parameters, strain measurements, the systolic-to-diastolic duration ratio, the myocardial performance (Tei) index, the RV/left ventricle (LV) diameter ratio, the LV eccentricity index, determination of an enlarged right atrium and RV size, and RV volume determination by 3-dimensional echocardiography. Here, we discuss the potential use and limitations of TTE techniques in children with PH and/or ventricular dysfunction. We suggest a protocol for TTE assessment of PH and myocardial function that helps to identify PH patients and their response to pharmacotherapy. The outlined protocol focuses on the detailed assessment of the hypertensive RV; RV-LV crosstalk must be analyzed separately in the evaluation of different pathologies that account for pediatric PH.

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Section: Tissue Doppler Velocitiesmentioning

confidence: 99%

Section: Tissue Doppler Velocitiesmentioning

confidence: 99%

Transthoracic Echocardiography in the Evaluation of Pediatric Pulmonary Hypertension and Ventricular Dysfunction

et al. 2016

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“…TAPSV was affected by increasing age, with a steeper course of the curve for infants than for older children and adolescents. 15) Because of the developmental changes, we believed it was accurate to not use a fixed numerical value for the whole pediatric population but rather reference the TAPSV value to age. 11) Therefore, a TAPSV value (7.353 + 3.157 × AGE 1/2 -0.388 × AGE) 11) was taken as a cut-off point to discriminate between normal and impaired right ventricular systolic function in this study.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Late Right Ventricular Systolic Dysfunction in Pediatric Patients With Repaired Tetralogy of Fallot

Ji¹,

Mei²,

Wang³

et al. 2015

Int. Heart J.

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SummaryTo evaluate independent risk factors for late right ventricular systolic dysfunction after correction of Tetralogy of Fallot (TOF) in a single-centre, retrospective and observational clinical trial.Patients less than 3 years of age who underwent correction of TOF and subsequently routine clinical follow-up of more than 36 months were included in this study and were divided either into an experimental group (right ventricular systolic dysfunction) or a control group (normal right ventricular systolic function) according to the tricuspid annular peak systolic velocity (TAPSV) value measured by pulsed wave-tissue Doppler imaging (pulsed wave-TDI). The relevant data of all selected patients were investigated and analyzed.From January 2012 to December 2012, a total of 113 consecutive eligible patients were enrolled in this study and were divided either into an experimental group (n = 41) or control group (n = 72). Through univariate analysis and subsequent logistic regression, low preoperative arterial oxygen saturation (OR = 1.66, 95%CI 1.22-4.58, P = 0.0163), age less than 6 months at the time of surgery (OR = 3.45, 95%CI 1.87-9.17, P = 0.0021), and transannular patch (OR = 2.15, 95%CI 1.31-5.38, P = 0.0015) were 3 independent risk factors for late right ventricular systolic dysfunction after correction of TOF.This clinical trial suggested low preoperative arterial oxygen saturation was associated with late right ventricular systolic dysfunction after correction of TOF, and appropriate age at the time of surgery and selection of a proper surgical method to reconstruct the right ventricular outflow tract contributed to improving late right ventricular systolic function in pediatric patients with repaired TOF. (Int Heart J 2015; 56: 80-85)

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“…We note also that after surgery for tetralogy of Fallot, these parameters worsen continuously over time in pediatric and adolescent patients [2,3].The authors state that a need exists for a detailed evaluation of the RV function parameters (e.g., the S 0 in this pediatric population) [1]. They found that S 0 was significantly lower in the surgically treated CHD patient group than in the control group.…”

mentioning

confidence: 96%

“…We note also that after surgery for tetralogy of Fallot, these parameters worsen continuously over time in pediatric and adolescent patients [2,3].…”

mentioning

confidence: 99%

Ability of the Tricuspid Annular Peak Systolic Velocity (S′) to Detect Systolic Right Ventricular Impairment After Congenital Heart Defect Surgery in Pediatric Patients

Koestenberger

Ravekes

2013

Pediatr Cardiol

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opinion, this is an excellent manuscript describing impaired systolic and diastolic biventricular performance shortly after congenital heart defect (CHD) surgery.The authors clearly state that only tissue Doppler parameters such as the tricuspid annular peak systolic velocity (S 0 ) and the M-mode parameter tricuspid annular plane systolic excursion (TAPSE) were able to detect impairment of systolic right ventricular (RV) function [1].We completely agree with their findings and may add that in our opinion, this impairment can persist up to 1 year postoperatively. We note also that after surgery for tetralogy of Fallot, these parameters worsen continuously over time in pediatric and adolescent patients [2,3].The authors state that a need exists for a detailed evaluation of the RV function parameters (e.g., the S 0 in this pediatric population) [1]. They found that S 0 was significantly lower in the surgically treated CHD patient group than in the control group.For the convenience of the pediatric cardiology audience, we add that our group recently has published normal S 0 values with z-scores for healthy pediatric patients [4]. Given these available normal values, authors can compare the measured S 0 values with respective age-related normal z-score values.The remarkable study from Klitsie et al.[1] clearly supports the notion that the RV is highly susceptible to postoperative function impairment in pediatric patients. As pediatricians, we thank the authors for addressing the need for careful and systematic evaluation of the RV in pediatric patients before and after CHD correction and look forward to more interesting studies from this group. References 1. Klitsie LM, Hazekamp MG, Roest AA, Van der Hulst AE, Gesinkvan der Veer BJ, Kuipers IM, Blom NA, Ten Harkel AD (2012) Tissue doppler imaging detects impaired biventricular performance shortly after congenital heart defect surgery. Pediatr Cardiol.

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Tricuspid Annular Peak Systolic Velocity (S′) in Children and Young Adults with Pulmonary Artery Hypertension Secondary to Congenital Heart Diseases, and in Those with Repaired Tetralogy of Fallot: Echocardiography and MRI Data

Cited by 56 publications

References 35 publications

Transthoracic Echocardiography in the Evaluation of Pediatric Pulmonary Hypertension and Ventricular Dysfunction

Transthoracic Echocardiography in the Evaluation of Pediatric Pulmonary Hypertension and Ventricular Dysfunction

Risk Factors for Late Right Ventricular Systolic Dysfunction in Pediatric Patients With Repaired Tetralogy of Fallot

Ability of the Tricuspid Annular Peak Systolic Velocity (S′) to Detect Systolic Right Ventricular Impairment After Congenital Heart Defect Surgery in Pediatric Patients

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