Usefulness of the Right Ventricular Systolic to Diastolic Duration Ratio to Predict Functional Capacity and Survival in Children With Pulmonary Arterial Hypertension

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

“…76 An increased S/D ratio > 1.4 inversely correlated with survival in pediatric PH. 76 Figure 6 shows an increased S/D ratio in a 15-yearold adolescent with PH-CHD.…”

“…In children with PH, a significantly impaired S/D ratio was proposed as an indicator of RV dysfunction as well as adverse ventricular-ventricular interactions. 76 Children with significant PH have a marked decrease in diastolic duration and an increased S/D ratio, compared to control subjects, that progressively worsened with increasing heart rate. 76 An increased S/D ratio > 1.4 inversely correlated with survival in pediatric PH.…”

“…76 Children with significant PH have a marked decrease in diastolic duration and an increased S/D ratio, compared to control subjects, that progressively worsened with increasing heart rate. 76 An increased S/D ratio > 1.4 inversely correlated with survival in pediatric PH. 76 Figure 6 shows an increased S/D ratio in a 15-yearold adolescent with PH-CHD.…”

Pulmonary hypertension in children

“…The S:D ratio is higher in PH patients than in controls (1.38 +/− 0.61 vs 0.72 +/− 0.16, p <0.001), and is associated with worse echocardiographic RV fractional area change, worse catheterization hemodynamics, shorter 6-minute walk distance, and worse clinical outcomes independent of pulmonary resistance or pressures (Figure 8). 56,60,61 . Tissue Doppler imaging directly measures myocardial velocities and has been shown to be an accurate measure of RV and LV systolic and diastolic function.…”

Goal-oriented therapy in paediatric pulmonary arterial hypertension: are we ready?

“…Functional class [11,12]; haemodynamic parameters (ratio of mean pulmonary arterial to systemic artery pressure [12], right atrial pressure .10 mmHg and pulmonary vascular resistance index (PVRI) .20 Wood units?m -1 [2,7,13]; brain natriuretic peptide (BNP)/N-terminal pro-BNP (BNP/NT-proBNP) [12,14,15] and echo parameters (systolic to diastolic duration ratio [16]; right to left ventricular diameter [17]; and tricuspid plane annular excursion (TAPSE) [11], have all been reported to correlate with outcome when measured at diagnosis. Some of these markers have indeed been used to elaborate the paediatric determinants of risk [1].…”