Document Detail


Tissue Doppler imaging following paediatric cardiac surgery: early patterns of change and relationship to outcome.
MedLine Citation:
PMID:  19447805     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Antony Vassalos; Stuart Lilley; David Young; Edward Peng; Kenneth MacArthur; James Pollock; Fiona Lyall; Mark H D Danton
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-05-15
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  9     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-24     Completed Date:  2009-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  173-7     Citation Subset:  IM    
Affiliation:
Royal Hospital for Sick Children, Yorkhill Division, Glasgow, UK.
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Cardiac Surgical Procedures* / adverse effects
Case-Control Studies
Child, Preschool
Echocardiography, Doppler*
Heart Septal Defects / physiopathology,  surgery*,  ultrasonography*
Humans
Infant
Myocardial Contraction
Myocardium / metabolism,  pathology
Predictive Value of Tests
Respiration, Artificial / adverse effects
Time Factors
Treatment Outcome
Troponin I / blood
Ventricular Function, Left
Ventricular Function, Right
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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