• Shahryar M Chowdhury, Ryan J Butts, Carolyn L Taylor, Varsha M Bandisode, Karen S Chessa, Anthony M Hlavacek, Girish S Shirali, and G Hamilton Baker.
• Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina. Electronic address: chowdhur@musc.edu.
• J Am Soc Echocardiogr. 2016 Jul 1; 29 (7): 640-7.

BackgroundThe accuracy of echocardiography in evaluating left ventricular contractility has not been validated in children. The objective of this study was to compare echocardiographic measures of contractility with those derived from pressure-volume loop (PVL) analysis in children.MethodsPatients with relatively normal loading conditions undergoing routine left heart catheterization were prospectively enrolled. PVLs were obtained via conductance catheters. The gold-standard measure of contractility, end-systolic elastance (Ees), was obtained via balloon occlusion of one or both vena cavae. Echocardiograms were performed immediately after PVL analysis under the same anesthetic conditions. Single-beat estimations of echocardiographic Ees were calculated using four different methods. These estimates were calculated using a combination of noninvasive blood pressure readings, ventricular volumes derived from three-dimensional echocardiography, and Doppler time intervals.ResultsOf 24 patients, 18 patients were heart transplant recipients, and six patients had small patent ductus arteriosus or small coronary fistulae. The mean age was 9.1 ± 5.6 years. The average invasive Ees was 3.04 ± 1.65 mm Hg/mL. Invasive Ees correlated best with echocardiographic Ees by the method of Tanoue (r = 0.85, P < .01), with a mean difference of -0.07 mm Hg/mL (95% limits of agreement, -2.0 to 1.4 mm Hg/mL).ConclusionsEchocardiographic estimates of Ees correlate well with gold-standard measures obtained via conductance catheters in children with relatively normal loading conditions. The use of these noninvasive measures in accurately assessing left ventricular contractility appears promising and merits further study in children.Copyright © 2016 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

23 keywords...

hide…