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

• Published in: Pediatric cardiology 2014-08, Vol.35 (6), p.998-1006
• Main Authors: Chowdhury, Shahryar M., Butts, Ryan J., Buckley, Jason, Hlavacek, Anthony M., Hsia, Tain-Yen, Khambadkone, Sachin, Baker, G. Hamilton
• Format: Article
• Language: English
• Subjects: Adolescent; Blood Pressure - physiology; Cardiac Catheterization - methods; Cardiac Surgery; Cardiology; Child; Child, Preschool; Comparative analysis; Comparative Effectiveness Research; Cross-Sectional Studies; Echocardiography, Doppler - methods; Female; Heart Defects, Congenital - diagnosis; Heart Defects, Congenital - physiopathology; Heart Ventricles - abnormalities; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Infant; Male; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Models, Cardiovascular; Original Article; Physiological aspects; Reproducibility of Results; United Kingdom; United States; Vascular Surgery; Ventricular Pressure - physiology
• ISSN: 0172-0643; 1432-1971
• DOI: 10.1007/s00246-014-0888-4

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 −d P /d t ), 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 −d P /d t 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.