Document Detail

Tissue Doppler imaging predicts adverse outcome in children with idiopathic pulmonary arterial hypertension.
MedLine Citation:
PMID:  22748515     Owner:  NLM     Status:  MEDLINE    
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.
Shinichi Takatsuki; Tomotaka Nakayama; Pei-Ni Jone; Brandie D Wagner; Kazuyuki Naoi; D Dunbar Ivy; Tsutomu Saji
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-06-28
Journal Detail:
Title:  The Journal of pediatrics     Volume:  161     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-22     Completed Date:  2013-01-22     Revised Date:  2013-12-05    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1126-31     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
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MeSH Terms
Biological Markers / blood
Blood Flow Velocity
Blood Pressure
Case-Control Studies
Disease-Free Survival
Echocardiography, Doppler, Color
Echocardiography, Doppler, Pulsed*
Exercise Test
Follow-Up Studies
Hypertension, Pulmonary / blood,  physiopathology,  ultrasonography*
Kaplan-Meier Estimate
Logistic Models
Natriuretic Peptide, Brain / blood
Prospective Studies
ROC Curve
Severity of Illness Index
Grant Support
Reg. No./Substance:
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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