| Tissue Doppler imaging predicts adverse outcome in children with idiopathic pulmonary arterial hypertension. | |
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MedLine Citation:
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PMID: 22748515 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the clinical utility of tissue Doppler imaging (TDI) in assessment of disease severity and prognostic value in children with idiopathic pulmonary arterial hypertension (PAH). STUDY DESIGN: A prospective study was performed to evaluate TDI velocities (systolic myocardial velocity, early diastolic myocardial relaxation velocity [Em], late diastolic myocardial velocity associated with atrial contraction), brain natriuretic peptide, New York Heart Association (NYHA) functional class, and hemodynamics in 51 children (mean age; 11.6 years) with idiopathic PAH. Fifty-one healthy children with comparable demographics served as controls. RESULTS: Em, Em/late diastolic myocardial velocity associated with atrial contraction ratio, and systolic myocardial velocity at mitral annulus, septum, and tricuspid annulus in PAH were significantly reduced compared with controls. Tricuspid Em had significant inverse correlations with plasma brain natriuretic peptide levels (r = -0.60, P < .001), right ventricular end-diastolic pressure (r = -0.79, P < .001), and mean pulmonary arterial pressure (r = -0.67, P < .001). Statistically significant differences were observed in tricuspid Em between NYHA functional class II vs combined III and IV (mean and SD; 11.9 ± 4.2 cm/s vs 8.2 ± 3.6 cm/s, respectively, P = .002). Cumulative event-free survival rate was significantly lower when tricuspid Em was ≤8 cm/s (log-rank test, P < .001) CONCLUSIONS: Tricuspid Em velocity correlated with NYHA functional class as disease severity and may serve as a useful prognostic marker in children with idiopathic PAH. The present study is the initial report to evaluate TDI velocities against midterm outcome variables in a relatively large pediatric PAH population. |
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Authors:
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Shinichi Takatsuki; Tomotaka Nakayama; Pei-Ni Jone; Brandie D Wagner; Kazuyuki Naoi; D Dunbar Ivy; Tsutomu Saji |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2012-06-28 |
Journal Detail:
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Title: The Journal of pediatrics Volume: 161 ISSN: 1097-6833 ISO Abbreviation: J. Pediatr. Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-11-22 Completed Date: 2013-01-22 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 0375410 Medline TA: J Pediatr Country: United States |
Other Details:
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Languages: eng Pagination: 1126-31 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2012 Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Biological Markers / blood Blood Flow Velocity Blood Pressure Case-Control Studies Child Disease-Free Survival Echocardiography, Doppler, Color Echocardiography, Doppler, Pulsed* Exercise Test Female Follow-Up Studies Humans Hypertension, Pulmonary / blood, physiopathology, ultrasonography* Kaplan-Meier Estimate Logistic Models Male Natriuretic Peptide, Brain / blood Prognosis Prospective Studies ROC Curve Severity of Illness Index |
| Grant Support | |
ID/Acronym/Agency:
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P50 HL084923/HL/NHLBI NIH HHS; UL1 RR025780/RR/NCRR NIH HHS; UL1 RR025780/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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