Sammendrag
Background:
Diastolic assessment of RV inflow using conventional Doppler simplifies complex blood flow into a single velocity and plane. Blood speckle tracking allows for visualization and quantification of complex flow not accounted for using conventional methods.
In this study we use blood speckle tracking (BST) to compare RV inflow in healthy children to those with congenital heart disease.
Methods:
A commercially available clinical scanner with research software enabling the acquisition of high-frame rate imaging was used to prospectively acquire a RV 4 chamber view in children with either an atrial septal defect (ASD), tetralogy of Fallot (TOF), pulmonary arterial hypertension (PAH), or healthy controls. Right ventricular rate of energy loss (EL), vorticity (Vo), kinetic energy (KE), and vector complexity (Vc)during early filling and atrial contraction were derived using custom in-house software.
Results:
Data from 111 children was analyzed (see table). Patients were older than controls however had similar weight and HR. ASD patients had significantly increased EL and KE during early filling and increased KE during atrial contraction. Patients with TOF had significantly increased EL, KE, and Vc during early filling
and
atrial contraction; Patients with PAH showed increased EL, KE, and Vc only during atrial contraction.
Conclusion:
Patients with congenital heart disease show abnormal diastolic RV flow patterns which vary with pathology. Flow assessment with BST could help improve RV diastolic assessment.
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