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Comparison of Pressure–Volume Loop and Echocardiographic Measures of Diastolic Function in Patients With a Single-Ventricle Physiology

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Abstract

Echocardiographic measurements of diastolic function have not been validated against invasive pressure–volume loop (PVL) analysis in the single-ventricle population. The authors hypothesized that echocardiographic measures of diastolic function would correlate with PVL indices of diastolic function in patients with a single-ventricle physiology. The conductance-derived PVL measures of diastolic function included the isovolumic relaxation time constant (τ), the maximum rate of ventricular pressure decline (peak −dP/dt), and a measure of passive diastolic stiffness (μ). The echocardiographic measures included Doppler inflow patterns of the dominant atrioventricular valve (DAVV), tissue Doppler velocities (TDI) at the lateral (ventricular free wall) component of the DAVV annulus, and the TDI-derived isovolumic relaxation time (IVRT′). The correlation between PVL and echocardiographic measures was examined. The study enrolled 13 patients at various stages of surgical palliation. The median age of the patients was 3 years (range 3 months to 19 years). τ correlated well with Doppler E:A (r = 0.832; p = 0.005), lateral E:E′ (r = 0.747; p = 0.033), and IVRT′ (r = 0.831; p = 0.001). Peak −dP/dt also was correlated with IVRT′ (r = 0.609; p = 0.036), and μ also was correlated with IVRT′ (r = 0.884; p = 0.001). This study represents the first-ever comparison of diastolic echocardiographic and PVL indices in a single-ventricle population. The findings show that Doppler E:A, lateral E:E′, and IVRT′ correlate well with PVL measures of diastolic function. This study supports further validation of echocardiographic measures of diastolic function versus PVL measures of diastolic function in the single-ventricle population.

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Acknowledgments

This study was funded by a Grant obtained through the Leducq Foundation.

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Authors and Affiliations

  1. Division of Cardiology, Department of Pediatrics, Medical University of South Carolina, 165 Ashley Avenue, MSC 915, Charleston, SC, 29425, USA

    Shahryar M. Chowdhury, Ryan J. Butts, Jason Buckley, Anthony M. Hlavacek & G. Hamilton Baker

  2. Department of Cardiothoracic Surgery, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK

    Tain-Yen Hsia

  3. Department of Cardiology, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK

    Sachin Khambadkone

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  1. Shahryar M. Chowdhury
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  2. Ryan J. Butts
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Correspondence to Shahryar M. Chowdhury.

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Chowdhury, S.M., Butts, R.J., Buckley, J. et al. Comparison of Pressure–Volume Loop and Echocardiographic Measures of Diastolic Function in Patients With a Single-Ventricle Physiology. Pediatr Cardiol 35, 998–1006 (2014). https://doi.org/10.1007/s00246-014-0888-4

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  • DOI: https://doi.org/10.1007/s00246-014-0888-4

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