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Tissue Doppler imaging following paediatric cardiac surgery: early patterns of change and relationship to outcome

Vassalos, A. and Lilley, S. and Young, D. and Peng, E. and MacArthur, K. and Pollock, J. and Lyall, F. and Danton, M.H.D. and , The Association of Children with Heart Disorders (Funder) (2009) Tissue Doppler imaging following paediatric cardiac surgery: early patterns of change and relationship to outcome. Interactive Cardiovascular and Thoracic Surgery, 9 (2). pp. 173-177. ISSN 1569-9293

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    Abstract

    In this study, tissue Doppler imaging (TDI) was used to assess changes in ventricular function following repair of congenital heart defects. The relationship between TDI indices, myocardial injury and clinical outcome was explored. Forty-five children were studied; 35 with cardiac lesions and 10 controls. TDI was performed preoperatively, on admission to paediatric intensive care unit (PICU) and day 1. Regional myocardial Doppler signals were acquired from the right ventricle (RV), left ventricle (LV) and septum. TDI indices included: peak systolic velocities, isovolumetric velocities (IVV) and isovolumetric acceleration (IVA). Preoperatively, bi-ventricular TDI velocities in the study group were reduced compared with normal controls. Postoperatively, RV velocities were significantly reduced and this persisted to day-1 (PreOp vs. PICU and day-1: 7.7+2.2 vs. 3.4+1.0, P < 0.0001 and 3.55+1.29, P < 0.0001). LV velocities initially declined but recovered towards baseline by day-1 (PreOp vs. PICU: 5.31+1.50 vs. 3.51+1.23, P < 0.0001). Isovolumetric parameters in all regions were reduced throughout the postoperative period. Troponin-I release correlated with longer X-clamp times (r=0.82, P < 0.0001) and reduced RV velocities (r=0.42, P=0.028). Reduced pre- and postoperative LV velocities correlated with longer ventilation (PreOp: r=0.54, P=0.002; PostOp: r=0.42, P=0.026). This study identified reduced postoperative RV velocities correlated with myocardial injury while reduced LV TDI correlated with longer postoperative ventilation.

    Item type: Article
    ID code: 14387
    Keywords: tissue doppler imaging, isovolumetric, paediatric cardiac surgery, troponin-i, Mathematics, Public health. Hygiene. Preventive Medicine
    Subjects: Science > Mathematics
    Medicine > Public aspects of medicine > Public health. Hygiene. Preventive Medicine
    Department: Faculty of Science > Mathematics and Statistics
    Related URLs:
      Depositing user: Mrs Ann Lynch
      Date Deposited: 22 Jan 2010 15:52
      Last modified: 17 Mar 2012 19:49
      URI: http://strathprints.strath.ac.uk/id/eprint/14387

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