Sammendrag
Background
Evaluation of left-ventricular diastolic function in pediatric cardiology remains challenging. Blood speckle tracking (BST) can estimate intraventricular pressure difference (IVPD) in early diastole. This allows for assessment of suction, an important determinant of LV filling. In this study we (1) perform invasive validation of the method and (2) study IVPD in children with single ventricles versus controls.
Methods
BST images were acquired using an ultrasound-scanner with research software (GE Vivid E-90/95). IVPD was calculated along the inflow visualized by 2D BST streamlines (Fig 1a) using custom-made analysis software.
Validation of IVPD estimates from BST was performed in an open chest porcine model (N=6). Micromanometer catheters were placed in the LV by apical puncture, one positioned basally in the LV inflow, the other in the apex. Apical LV four chamber (LV4C) BST images and invasive pressures were simultaneously acquired, and early diastolic IVPD from BST and invasive measurements were compared.
Children with functional single ventricles (SV) (N=27, age 0.6-10.6 years) and controls (N=95, age 0.5-10.0 years) were prospectively enrolled, and IVPD from LV4C BST acquisitions were compared.
Results
Analysis from 103 recordings in six different pigs demonstrated a high level of agreement between IVPD from invasive measurements and BST (r = 0.95 Fig 1b). IVPD in patients with SV were significantly lower than in controls (-1.03 ± 0.42 vs -2.28 ± 0.64 mmHg, p
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