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Forgotten Right Ventricle in Pediatric Dilated Cardiomyopathy.
Pediatr Cardiol. 2017 Apr; 38(4):819-827.PC

Abstract

To evaluate the right ventricular (RV) function in relation to that of the left ventricle (LV) in patients with dilated cardiomyopathy (DCM). Echocardiographic examination was done using tissue Doppler imaging (TDI) and two-dimensional speckle tracking echocardiography (2D-STE) for 32 pediatric patients with DCM comparing them to another 32 normal matched controls. The global longitudinal strain (GLS) derived from 2D-STE was used to reflect the LV systolic function. Tricuspid annular plan systolic excursion (TAPSE) and the following RV TDI derived indexes: peak systolic velocity (S'), peak early diastolic velocity E', peak late diastolic velocity A', isovolumic acceleration (IVA) and myocardial performance index (MPI) were measured. RV had significant systolic and diastolic dysfunction; TAPSE, S' velocity, IVA, peak early diastolic velocity (E') and peak early diastolic velocity/peak late diastolic velocity (E'/A') ratio were significantly decreased while MPI was significantly prolonged compared to controls. Moreover, TAPSE, S', IVA, E', E'/A' and RV MPI were significantly correlated to LV GLS. For prediction of LV dysfunction among patients, the area under the receiver operating characteristic curve was 0.98 for RV MPI, 0.906 for RV IVA. For identifying severe LV dysfunction; RV MPI > 0.29 had 100% sensitivity and 93.7% specificity, while the RV IVA ≤ 3 had 84.4% sensitivity and 90.6% specificity. In pediatric patients with DCM the RV systolic and diastolic functions are affected beside the LV dysfunction. Non-conventional echocardiographic evaluation of RV function is recommended in among this cohort.

Authors+Show Affiliations

Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Specialized Pediatric Hospital, Cairo University, Kasr Al Aini Street, Cairo, 11562, Egypt. halaazza@gmail.com.Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Specialized Pediatric Hospital, Cairo University, Kasr Al Aini Street, Cairo, 11562, Egypt.Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Specialized Pediatric Hospital, Cairo University, Kasr Al Aini Street, Cairo, 11562, Egypt.Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Specialized Pediatric Hospital, Cairo University, Kasr Al Aini Street, Cairo, 11562, Egypt.Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Specialized Pediatric Hospital, Cairo University, Kasr Al Aini Street, Cairo, 11562, Egypt.Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Specialized Pediatric Hospital, Cairo University, Kasr Al Aini Street, Cairo, 11562, Egypt.Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Specialized Pediatric Hospital, Cairo University, Kasr Al Aini Street, Cairo, 11562, Egypt.Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Specialized Pediatric Hospital, Cairo University, Kasr Al Aini Street, Cairo, 11562, Egypt.Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Specialized Pediatric Hospital, Cairo University, Kasr Al Aini Street, Cairo, 11562, Egypt.Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Specialized Pediatric Hospital, Cairo University, Kasr Al Aini Street, Cairo, 11562, Egypt.Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Specialized Pediatric Hospital, Cairo University, Kasr Al Aini Street, Cairo, 11562, Egypt.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28315942

Citation

Agha, Hala Mounir, et al. "Forgotten Right Ventricle in Pediatric Dilated Cardiomyopathy." Pediatric Cardiology, vol. 38, no. 4, 2017, pp. 819-827.
Agha HM, Ibrahim H, El Satar IA, et al. Forgotten Right Ventricle in Pediatric Dilated Cardiomyopathy. Pediatr Cardiol. 2017;38(4):819-827.
Agha, H. M., Ibrahim, H., El Satar, I. A., El Rahman, N. A., El Aziz, D. A., Salah, Z., El Saeidi, S., Mostafa, F., Attia, W., El Rahman, M. A., & El Mohsen, G. A. (2017). Forgotten Right Ventricle in Pediatric Dilated Cardiomyopathy. Pediatric Cardiology, 38(4), 819-827. https://doi.org/10.1007/s00246-017-1588-7
Agha HM, et al. Forgotten Right Ventricle in Pediatric Dilated Cardiomyopathy. Pediatr Cardiol. 2017;38(4):819-827. PubMed PMID: 28315942.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Forgotten Right Ventricle in Pediatric Dilated Cardiomyopathy. AU - Agha,Hala Mounir, AU - Ibrahim,Hossam, AU - El Satar,Inas Abd, AU - El Rahman,Naglae Abd, AU - El Aziz,Doaa Abd, AU - Salah,Zeinab, AU - El Saeidi,Sonia, AU - Mostafa,Fatma, AU - Attia,Wael, AU - El Rahman,Mohamed Abd, AU - El Mohsen,Gaser Abd, Y1 - 2017/03/18/ PY - 2016/07/31/received PY - 2017/02/10/accepted PY - 2017/3/21/pubmed PY - 2017/10/11/medline PY - 2017/3/20/entrez KW - 2D-speckle tracking KW - Dilated cardiomyopathy KW - Isovolumic acceleration KW - Right ventricle KW - Tissue Doppler imaging SP - 819 EP - 827 JF - Pediatric cardiology JO - Pediatr Cardiol VL - 38 IS - 4 N2 - To evaluate the right ventricular (RV) function in relation to that of the left ventricle (LV) in patients with dilated cardiomyopathy (DCM). Echocardiographic examination was done using tissue Doppler imaging (TDI) and two-dimensional speckle tracking echocardiography (2D-STE) for 32 pediatric patients with DCM comparing them to another 32 normal matched controls. The global longitudinal strain (GLS) derived from 2D-STE was used to reflect the LV systolic function. Tricuspid annular plan systolic excursion (TAPSE) and the following RV TDI derived indexes: peak systolic velocity (S'), peak early diastolic velocity E', peak late diastolic velocity A', isovolumic acceleration (IVA) and myocardial performance index (MPI) were measured. RV had significant systolic and diastolic dysfunction; TAPSE, S' velocity, IVA, peak early diastolic velocity (E') and peak early diastolic velocity/peak late diastolic velocity (E'/A') ratio were significantly decreased while MPI was significantly prolonged compared to controls. Moreover, TAPSE, S', IVA, E', E'/A' and RV MPI were significantly correlated to LV GLS. For prediction of LV dysfunction among patients, the area under the receiver operating characteristic curve was 0.98 for RV MPI, 0.906 for RV IVA. For identifying severe LV dysfunction; RV MPI > 0.29 had 100% sensitivity and 93.7% specificity, while the RV IVA ≤ 3 had 84.4% sensitivity and 90.6% specificity. In pediatric patients with DCM the RV systolic and diastolic functions are affected beside the LV dysfunction. Non-conventional echocardiographic evaluation of RV function is recommended in among this cohort. SN - 1432-1971 UR - https://www.unboundmedicine.com/medline/citation/28315942/Forgotten_Right_Ventricle_in_Pediatric_Dilated_Cardiomyopathy_ L2 - https://dx.doi.org/10.1007/s00246-017-1588-7 DB - PRIME DP - Unbound Medicine ER -