Tissue Doppler imaging following paediatric cardiac surgery

early patterns of change and relationship to outcome

Antony Vassalos, Stuart Lilley, David Young, Edward Peng, Kenneth MacArthur, James Pollock, Fiona Lyall, Mark H. D. Danton, The Association of Children with Heart Disorders (Funder)

Research output: Contribution to journalArticle

16 Citations (Scopus)
116 Downloads (Pure)

Abstract

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 withcardiac 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 systolicvelocities, isovolumetric velocities (IVV) and isovolumetric acceleration (IVA). Preoperatively, bi-ventricular TDI velocities in the study groupwere 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.
Original languageEnglish
Pages (from-to)173-177
Number of pages5
JournalInteractive Cardiovascular and Thoracic Surgery
Volume9
Issue number2
DOIs
Publication statusPublished - 1 Aug 2009

Fingerprint

Thoracic Surgery
Heart Ventricles
Pediatrics
Pediatric Intensive Care Units
Ventilation
Troponin I
Ventricular Function
Congenital Heart Defects
Wounds and Injuries
Postoperative Period

Keywords

  • tissue doppler imaging
  • isovolumetric
  • paediatric cardiac surgery
  • troponin-i

Cite this

Vassalos, A., Lilley, S., Young, D., Peng, E., MacArthur, K., Pollock, J., ... The Association of Children with Heart Disorders (Funder) (2009). Tissue Doppler imaging following paediatric cardiac surgery: early patterns of change and relationship to outcome. Interactive Cardiovascular and Thoracic Surgery, 9(2), 173-177. https://doi.org/10.1510/icvts.2008.201723
Vassalos, Antony ; Lilley, Stuart ; Young, David ; Peng, Edward ; MacArthur, Kenneth ; Pollock, James ; Lyall, Fiona ; Danton, Mark H. D. ; The Association of Children with Heart Disorders (Funder). / Tissue Doppler imaging following paediatric cardiac surgery : early patterns of change and relationship to outcome. In: Interactive Cardiovascular and Thoracic Surgery. 2009 ; Vol. 9, No. 2. pp. 173-177.
@article{541c4129fd4a4e6288b71584c0002e3e,
title = "Tissue Doppler imaging following paediatric cardiac surgery: early patterns of change and relationship to outcome",
abstract = "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 withcardiac 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 systolicvelocities, isovolumetric velocities (IVV) and isovolumetric acceleration (IVA). Preoperatively, bi-ventricular TDI velocities in the study groupwere 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.",
keywords = "tissue doppler imaging, isovolumetric, paediatric cardiac surgery, troponin-i",
author = "Antony Vassalos and Stuart Lilley and David Young and Edward Peng and Kenneth MacArthur and James Pollock and Fiona Lyall and Danton, {Mark H. D.} and {The Association of Children with Heart Disorders (Funder)}",
year = "2009",
month = "8",
day = "1",
doi = "10.1510/icvts.2008.201723",
language = "English",
volume = "9",
pages = "173--177",
journal = "Interactive Cardiovascular and Thoracic Surgery",
issn = "1569-9293",
number = "2",

}

Vassalos, A, Lilley, S, Young, D, Peng, E, MacArthur, K, Pollock, J, Lyall, F, Danton, MHD & The Association of Children with Heart Disorders (Funder) 2009, 'Tissue Doppler imaging following paediatric cardiac surgery: early patterns of change and relationship to outcome', Interactive Cardiovascular and Thoracic Surgery, vol. 9, no. 2, pp. 173-177. https://doi.org/10.1510/icvts.2008.201723

Tissue Doppler imaging following paediatric cardiac surgery : early patterns of change and relationship to outcome. / Vassalos, Antony; Lilley, Stuart; Young, David; Peng, Edward; MacArthur, Kenneth; Pollock, James; Lyall, Fiona; Danton, Mark H. D.; The Association of Children with Heart Disorders (Funder).

In: Interactive Cardiovascular and Thoracic Surgery, Vol. 9, No. 2, 01.08.2009, p. 173-177.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Tissue Doppler imaging following paediatric cardiac surgery

T2 - early patterns of change and relationship to outcome

AU - Vassalos, Antony

AU - Lilley, Stuart

AU - Young, David

AU - Peng, Edward

AU - MacArthur, Kenneth

AU - Pollock, James

AU - Lyall, Fiona

AU - Danton, Mark H. D.

AU - The Association of Children with Heart Disorders (Funder)

PY - 2009/8/1

Y1 - 2009/8/1

N2 - 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 withcardiac 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 systolicvelocities, isovolumetric velocities (IVV) and isovolumetric acceleration (IVA). Preoperatively, bi-ventricular TDI velocities in the study groupwere 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.

AB - 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 withcardiac 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 systolicvelocities, isovolumetric velocities (IVV) and isovolumetric acceleration (IVA). Preoperatively, bi-ventricular TDI velocities in the study groupwere 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.

KW - tissue doppler imaging

KW - isovolumetric

KW - paediatric cardiac surgery

KW - troponin-i

U2 - 10.1510/icvts.2008.201723

DO - 10.1510/icvts.2008.201723

M3 - Article

VL - 9

SP - 173

EP - 177

JO - Interactive Cardiovascular and Thoracic Surgery

JF - Interactive Cardiovascular and Thoracic Surgery

SN - 1569-9293

IS - 2

ER -