Document Detail


Usefulness of the right ventricular systolic to diastolic duration ratio to predict functional capacity and survival in children with pulmonary arterial hypertension.
MedLine Citation:
PMID:  20643259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this study was to investigate the systolic to diastolic duration ratio (S:D ratio) in children with pulmonary arterial hypertension (PAH) and its association with right ventricular (RV) performance, hemodynamics, 6-minute walk test, clinical outcomes, and survival. We reviewed 503 serial echocardiograms in 47 children with PAH (mean pulmonary artery pressure >or=25 mm Hg) and compared the S:D ratio, assessed from Doppler flow of tricuspid valve regurgitation, to that in 47 age-matched controls. We reviewed echocardiograms, catheterization data, 6-minute walk tests, clinical data, lung transplantation, and death and used univariate linear regression models with a maximum likelihood algorithm for parameter estimation to investigate associations between S:D ratio and RV function, hemodynamics, functional capacity, and clinical outcomes. The S:D ratio was significantly higher in patients than in controls (1.38 +/- 0.61 vs 0.72 +/- 0.16, p <0.001). A higher S:D ratio was associated with worse echocardiographic RV fractional area of change, worse catheterization hemodynamics, shorter 6-minute walk distance, and worse clinical outcomes independent of pulmonary resistance or pressures. An increase of 0.1 in the S:D ratio was associated with a 13% increase in yearly risk for lung transplantation or death (hazard ratio 1.13, p <0.001). An S:D ratio 1.00 to 1.40 was associated with a moderate risk and an S:D ratio >1.40 was associated with a high risk of a negative outcome. In conclusion, in children with PAH, an increased S:D ratio is temporally associated with worse RV function, hemodynamics, exercise capability, clinical status, and survival.
Authors:
Jaime Alkon; Tilman Humpl; Cedric Manlhiot; Brian W McCrindle; Janette T Reyes; Mark K Friedberg
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Publication Detail:
Type:  Journal Article     Date:  2010-06-18
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-20     Completed Date:  2010-08-12     Revised Date:  2010-11-23    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  430-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 Elsevier Inc. All rights reserved.
Affiliation:
Division of Pediatric Cardiology, The Labatt Family Heart Center, Hospital for Sick Children, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Case-Control Studies
Child
Child, Preschool
Diastole
Echocardiography, Doppler
Exercise Test
Female
Hemodynamics
Humans
Hypertension, Pulmonary / physiopathology*,  ultrasonography
Infant
Infant, Newborn
Linear Models
Male
Predictive Value of Tests
Respiratory Function Tests
Survival Analysis
Systole
Ventricular Dysfunction, Right / physiopathology,  ultrasonography
Young Adult
Comments/Corrections
Comment In:
Am J Cardiol. 2010 Nov 15;106(10):1524   [PMID:  21059452 ]

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


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