TY - JOUR
T1 - Doppler tissue imaging in children following cardiac transplantation
T2 - A comparison to catheter derived hemodynamics
AU - Goldberg, David J.
AU - Quartermain, Michael D.
AU - Glatz, Andrew C.
AU - Hall, E. Kevin
AU - Davis, Erin
AU - Kren, Stephanie A.
AU - Hanna, Brian D.
AU - Cohen, Meryl S.
PY - 2011/8
Y1 - 2011/8
N2 - Previous studies have demonstrated a correlation between E:E a and ventricular filling pressure in adults after heart transplantation. We sought to determine if E:E a correlates with filling pressure after heart transplantation in children. A prospective analysis of children who have undergone heart transplantation was performed. Inflow and myocardial velocities were recorded and compared to catheter-derived filling pressures and rejection status. We performed 61 studies in 49 subjects. No correlation was found between septal E:E a and PCWP (r = 0.14, p = 0.28); or between lateral tricuspid E:E a and mean RAp (r = 0.04, p = 0.79). However, the mean PCWP was higher among subjects with elevated septal E:E a (>12) compared to normal E:E a (12.3 ± 2.8 mmHg vs. 10.1 ± 2.9 mmHg, p = 0.02). Similarly, mean RAp was higher among subjects with an elevated lateral tricuspid E:E a (>10) compared to normal lateral tricuspid E:E a (7.7 ± 2.1 mmHg vs. 6.0 ± 2.4 mmHg, p = 0.04). Elevated septal E:E a was also associated with high-grade cellular rejection (OR = 17.3 [95% CI 1.4-221], p = 0.028). In children following heart transplant, E:E a does not correlate well with the range of filling pressures seen after pediatric heart transplantation. However, a septal E:E a > 12 is associated with elevated PCWP and high grade cellular rejection and a lateral tricuspid E:E a > 10 is associated with elevated mean RAp.
AB - Previous studies have demonstrated a correlation between E:E a and ventricular filling pressure in adults after heart transplantation. We sought to determine if E:E a correlates with filling pressure after heart transplantation in children. A prospective analysis of children who have undergone heart transplantation was performed. Inflow and myocardial velocities were recorded and compared to catheter-derived filling pressures and rejection status. We performed 61 studies in 49 subjects. No correlation was found between septal E:E a and PCWP (r = 0.14, p = 0.28); or between lateral tricuspid E:E a and mean RAp (r = 0.04, p = 0.79). However, the mean PCWP was higher among subjects with elevated septal E:E a (>12) compared to normal E:E a (12.3 ± 2.8 mmHg vs. 10.1 ± 2.9 mmHg, p = 0.02). Similarly, mean RAp was higher among subjects with an elevated lateral tricuspid E:E a (>10) compared to normal lateral tricuspid E:E a (7.7 ± 2.1 mmHg vs. 6.0 ± 2.4 mmHg, p = 0.04). Elevated septal E:E a was also associated with high-grade cellular rejection (OR = 17.3 [95% CI 1.4-221], p = 0.028). In children following heart transplant, E:E a does not correlate well with the range of filling pressures seen after pediatric heart transplantation. However, a septal E:E a > 12 is associated with elevated PCWP and high grade cellular rejection and a lateral tricuspid E:E a > 10 is associated with elevated mean RAp.
KW - echocardiography
KW - pediatric heart transplant
UR - http://www.scopus.com/inward/record.url?scp=79960584242&partnerID=8YFLogxK
U2 - 10.1111/j.1399-3046.2011.01503.x
DO - 10.1111/j.1399-3046.2011.01503.x
M3 - Review article
C2 - 21518161
AN - SCOPUS:79960584242
SN - 1397-3142
VL - 15
SP - 488
EP - 494
JO - Pediatric Transplantation
JF - Pediatric Transplantation
IS - 5
ER -