Comparison of echocardiographic measurements to invasive measurements of diastolic function in infants with single ventricle physiology

A report from the Pediatric Heart Network Infant Single Ventricle Trial

Suma P. Goudar, Victor Zak, Andrew M. Atz, Karen Altmann, Steven D. Colan, Christine B. Falkensammer, Mark K. Friedberg, Michele Frommelt, Kevin D. Hill, Daphne T. Hsu, Jami C. Levine, Renee Margossian, Christopher R. Mart, Joshua Sticka, Peter Shrader, Girish Shirali

Research output: Contribution to journalArticle

Abstract

Background:While echocardiographic parameters are used to quantify ventricular function in infants with single ventricle physiology, there are few data comparing these to invasive measurements. This study correlates echocardiographic measures of diastolic function with ventricular end-diastolic pressure in infants with single ventricle physiology prior to superior cavopulmonary anastomosis.Methods:Data from 173 patients enrolled in the Pediatric Heart Network Infant Single Ventricle enalapril trial were analysed. Those with mixed ventricular types (n = 17) and one outlier (end-diastolic pressure = 32 mmHg) were excluded from the analysis, leaving a total sample size of 155 patients. Echocardiographic measurements were correlated to end-diastolic pressure using Spearman's test.Results:Median age at echocardiogram was 4.6 (range 2.5-7.4) months. Median ventricular end-diastolic pressure was 7 (range 3-19) mmHg. Median time difference between the echocardiogram and catheterisation was 0 days (range -35 to 59 days). Examining the entire cohort of 155 patients, no echocardiographic diastolic function variable correlated with ventricular end-diastolic pressure. When the analysis was limited to the 86 patients who had similar sedation for both studies, the systolic:diastolic duration ratio had a significant but weak negative correlation with end-diastolic pressure (r = -0.3, p = 0.004). The remaining echocardiographic variables did not correlate with ventricular end-diastolic pressure.Conclusion:In this cohort of infants with single ventricle physiology prior to superior cavopulmonary anastomosis, most conventional echocardiographic measures of diastolic function did not correlate with ventricular end-diastolic pressure at cardiac catheterisation. These limitations should be factored into the interpretation of quantitative echo data in this patient population.

Original languageEnglish (US)
JournalCardiology in the Young
DOIs
StateAccepted/In press - Jan 1 2019

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Pediatrics
Blood Pressure
Right Heart Bypass
Ventricular Function
Enalapril
Cardiac Catheterization
Catheterization
Sample Size
Population

Keywords

  • Diastolic function
  • infants
  • single ventricle

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of echocardiographic measurements to invasive measurements of diastolic function in infants with single ventricle physiology : A report from the Pediatric Heart Network Infant Single Ventricle Trial. / Goudar, Suma P.; Zak, Victor; Atz, Andrew M.; Altmann, Karen; Colan, Steven D.; Falkensammer, Christine B.; Friedberg, Mark K.; Frommelt, Michele; Hill, Kevin D.; Hsu, Daphne T.; Levine, Jami C.; Margossian, Renee; Mart, Christopher R.; Sticka, Joshua; Shrader, Peter; Shirali, Girish.

In: Cardiology in the Young, 01.01.2019.

Research output: Contribution to journalArticle

Goudar, SP, Zak, V, Atz, AM, Altmann, K, Colan, SD, Falkensammer, CB, Friedberg, MK, Frommelt, M, Hill, KD, Hsu, DT, Levine, JC, Margossian, R, Mart, CR, Sticka, J, Shrader, P & Shirali, G 2019, 'Comparison of echocardiographic measurements to invasive measurements of diastolic function in infants with single ventricle physiology: A report from the Pediatric Heart Network Infant Single Ventricle Trial', Cardiology in the Young. https://doi.org/10.1017/S1047951119001859
Goudar, Suma P. ; Zak, Victor ; Atz, Andrew M. ; Altmann, Karen ; Colan, Steven D. ; Falkensammer, Christine B. ; Friedberg, Mark K. ; Frommelt, Michele ; Hill, Kevin D. ; Hsu, Daphne T. ; Levine, Jami C. ; Margossian, Renee ; Mart, Christopher R. ; Sticka, Joshua ; Shrader, Peter ; Shirali, Girish. / Comparison of echocardiographic measurements to invasive measurements of diastolic function in infants with single ventricle physiology : A report from the Pediatric Heart Network Infant Single Ventricle Trial. In: Cardiology in the Young. 2019.
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abstract = "Background:While echocardiographic parameters are used to quantify ventricular function in infants with single ventricle physiology, there are few data comparing these to invasive measurements. This study correlates echocardiographic measures of diastolic function with ventricular end-diastolic pressure in infants with single ventricle physiology prior to superior cavopulmonary anastomosis.Methods:Data from 173 patients enrolled in the Pediatric Heart Network Infant Single Ventricle enalapril trial were analysed. Those with mixed ventricular types (n = 17) and one outlier (end-diastolic pressure = 32 mmHg) were excluded from the analysis, leaving a total sample size of 155 patients. Echocardiographic measurements were correlated to end-diastolic pressure using Spearman's test.Results:Median age at echocardiogram was 4.6 (range 2.5-7.4) months. Median ventricular end-diastolic pressure was 7 (range 3-19) mmHg. Median time difference between the echocardiogram and catheterisation was 0 days (range -35 to 59 days). Examining the entire cohort of 155 patients, no echocardiographic diastolic function variable correlated with ventricular end-diastolic pressure. When the analysis was limited to the 86 patients who had similar sedation for both studies, the systolic:diastolic duration ratio had a significant but weak negative correlation with end-diastolic pressure (r = -0.3, p = 0.004). The remaining echocardiographic variables did not correlate with ventricular end-diastolic pressure.Conclusion:In this cohort of infants with single ventricle physiology prior to superior cavopulmonary anastomosis, most conventional echocardiographic measures of diastolic function did not correlate with ventricular end-diastolic pressure at cardiac catheterisation. These limitations should be factored into the interpretation of quantitative echo data in this patient population.",
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T1 - Comparison of echocardiographic measurements to invasive measurements of diastolic function in infants with single ventricle physiology

T2 - A report from the Pediatric Heart Network Infant Single Ventricle Trial

AU - Goudar, Suma P.

AU - Zak, Victor

AU - Atz, Andrew M.

AU - Altmann, Karen

AU - Colan, Steven D.

AU - Falkensammer, Christine B.

AU - Friedberg, Mark K.

AU - Frommelt, Michele

AU - Hill, Kevin D.

AU - Hsu, Daphne T.

AU - Levine, Jami C.

AU - Margossian, Renee

AU - Mart, Christopher R.

AU - Sticka, Joshua

AU - Shrader, Peter

AU - Shirali, Girish

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background:While echocardiographic parameters are used to quantify ventricular function in infants with single ventricle physiology, there are few data comparing these to invasive measurements. This study correlates echocardiographic measures of diastolic function with ventricular end-diastolic pressure in infants with single ventricle physiology prior to superior cavopulmonary anastomosis.Methods:Data from 173 patients enrolled in the Pediatric Heart Network Infant Single Ventricle enalapril trial were analysed. Those with mixed ventricular types (n = 17) and one outlier (end-diastolic pressure = 32 mmHg) were excluded from the analysis, leaving a total sample size of 155 patients. Echocardiographic measurements were correlated to end-diastolic pressure using Spearman's test.Results:Median age at echocardiogram was 4.6 (range 2.5-7.4) months. Median ventricular end-diastolic pressure was 7 (range 3-19) mmHg. Median time difference between the echocardiogram and catheterisation was 0 days (range -35 to 59 days). Examining the entire cohort of 155 patients, no echocardiographic diastolic function variable correlated with ventricular end-diastolic pressure. When the analysis was limited to the 86 patients who had similar sedation for both studies, the systolic:diastolic duration ratio had a significant but weak negative correlation with end-diastolic pressure (r = -0.3, p = 0.004). The remaining echocardiographic variables did not correlate with ventricular end-diastolic pressure.Conclusion:In this cohort of infants with single ventricle physiology prior to superior cavopulmonary anastomosis, most conventional echocardiographic measures of diastolic function did not correlate with ventricular end-diastolic pressure at cardiac catheterisation. These limitations should be factored into the interpretation of quantitative echo data in this patient population.

AB - Background:While echocardiographic parameters are used to quantify ventricular function in infants with single ventricle physiology, there are few data comparing these to invasive measurements. This study correlates echocardiographic measures of diastolic function with ventricular end-diastolic pressure in infants with single ventricle physiology prior to superior cavopulmonary anastomosis.Methods:Data from 173 patients enrolled in the Pediatric Heart Network Infant Single Ventricle enalapril trial were analysed. Those with mixed ventricular types (n = 17) and one outlier (end-diastolic pressure = 32 mmHg) were excluded from the analysis, leaving a total sample size of 155 patients. Echocardiographic measurements were correlated to end-diastolic pressure using Spearman's test.Results:Median age at echocardiogram was 4.6 (range 2.5-7.4) months. Median ventricular end-diastolic pressure was 7 (range 3-19) mmHg. Median time difference between the echocardiogram and catheterisation was 0 days (range -35 to 59 days). Examining the entire cohort of 155 patients, no echocardiographic diastolic function variable correlated with ventricular end-diastolic pressure. When the analysis was limited to the 86 patients who had similar sedation for both studies, the systolic:diastolic duration ratio had a significant but weak negative correlation with end-diastolic pressure (r = -0.3, p = 0.004). The remaining echocardiographic variables did not correlate with ventricular end-diastolic pressure.Conclusion:In this cohort of infants with single ventricle physiology prior to superior cavopulmonary anastomosis, most conventional echocardiographic measures of diastolic function did not correlate with ventricular end-diastolic pressure at cardiac catheterisation. These limitations should be factored into the interpretation of quantitative echo data in this patient population.

KW - Diastolic function

KW - infants

KW - single ventricle

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