Research Article
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Evaluation of left ventricular functions by conventional echocardiography and tissue Doppler imaging in children with rheumatic valve disease

Year 2018, Volume: 8 Issue: 1, 1 - 6, 17.04.2018
https://doi.org/10.16899/gopctd.369657

Abstract



Aim: We aimed to evaluate left ventricular
functions in children with mitral regurgitation (MR) who were followed up with
the diagnosis
rheumatic carditis, by using conventional echocardiography and tissue
Doppler imaging (TDI) and compare the
results with those of healthy control subjects.



Materials and Methods: 30 patients who were followed up with the diagnosis of MR due to sequel of rheumatic carditis in our pediatric cardiology clinic and 30 healthy children aged between 5-15 years were included in the study. The patient group was categorized as mild-moderate MR (n: 20), and severe MR (n: 10). All echocardiographic and Doppler assessments were performed by a single expert pediatric cardiologist, who was blinded to the clinical and laboratory results of the study group

Results: LV end-diastolic diameters  were significantly increased in patient with severe MR compared to controls (4.62 ±0.82cm, 3.92±0.39cm; p:0.008). Also LV end-systolic diameters were found significantly increased in patient with severe MR compared to controls (2.81±0.51, 2.43±0.25, p:0.01). There was no statistically significant difference between groups in terms of LV ejection fraction and fractional shortening (p>0.05). Although peak early diastolic myocardial velocity obtained with TDI did not show significantly difference between the groups (p>0.05), peak atrial systolic velocity measured from the lateral and septal annulus were significantly increased in patients with severe MR when compared with controls and patients with mild--modarete MR (p<0.001, p:0.001; respectively).

Conclusion: In our study, LV systolic and diastolic functions obtained by conventional echocardiographic measurements, showed no significant difference between the controls and patients with MR. However, deterioration in subclinical LV systolic and diastolic function was detected by TDI the patient group with MR. 


Aim: We aimed to evaluate left ventricular functions in children with mitral regurgitation (MR) who were followed up with the diagnosis rheumatic carditis, by using conventional echocardiography and tissue Doppler imaging (TDI) and compare the
results with those of healthy control subjects.



Materials and Methods: 30 patients who were followed up with the diagnosis of MR due to sequel of rheumatic carditis in our pediatric cardiology clinic and 30 healthy children aged between 5-15 years were included in the study. The patient group was categorized as mild-moderate MR (n: 20), and severe MR (n: 10). All echocardiographic and Doppler assessments were performed by a single expert pediatric cardiologist, who was blinded to the clinical and laboratory results of the study group

Results: LV end-diastolic diameters  were significantly increased in patient with severe MR compared to controls (4.62 ±0.82cm, 3.92±0.39cm; p:0.008). Also LV end-systolic diameters were found significantly increased in patient with severe MR compared to controls (2.81±0.51, 2.43±0.25, p:0.01). There was no statistically significant difference between groups in terms of LV ejection fraction and fractional shortening (p>0.05). Although peak early diastolic myocardial velocity obtained with TDI did not show significantly difference between the groups (p>0.05), peak atrial systolic velocity measured from the lateral and septal annulus were significantly increased in patients with severe MR when compared with controls and patients with mild--modarete MR (p<0.001, p:0.001; respectively).

Conclusion: In our study, LV systolic and diastolic functions obtained by conventional echocardiographic measurements, showed no significant difference between the controls and patients with MR. However, deterioration in subclinical LV systolic and diastolic function was detected by TDI the patient group with MR. 


References

  • Gewitz MH, Baltimore RS, Tani LY etal. American Heart Association Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: a scientific statement from the American Heart Association. Circulation 2015;131(20):1806-18.
  • Myung K. Park. Pediatric cardiology for Practitioners. 4th ed. San Antorino: Texas; 2002.
  • Fujikawa S. Guidelines for the diagnosis of rheumatic fever: Jones criteria, updated 1992. Ryumachi 1993;33(5):451-5.
  • Enriquez-Sarano M, Tajik A, Schaff H, et al. Echocardiographic prediction of left ventricular function after correction of MR: results and clinical implications. J Am Coll Cardiol 1994;24:1536–43.
  • Polat TB, Yalcin Y, Erdem A, Zeybek C, Akdeniz C, Celebi A. Tissue Doppler imaging in rheumatic carditis. Cardiol Young. 2014 Apr;24(2):359-65.
  • Nazli C, Kinay O, Ergene O et al. Use of tissue Doppler echocardiography in early detection of left ventricular systolic dysfunction in patients with MR. Int J Cardiovasc Imaging 2003;19(3):199-209.
  • Isaaz K, Thompson A, Ethevenot G, Cloez JL, Brembilla B, Pernot C. Doppler echocardiographic measurement of low velocity motion of the left ventricular posterior wall. Am J Cardiol 1989;64(1):66-75.
  • Mc Dicken WN, Sutherland GR, Moran CM, Gordon L. Colour Doppler velocity imaging of the myocardium. Ultrasound Med Biol 1992;18:651-4
  • Agricola E, Galderisi M, Oppizzi M et al. Pulsed tissue Doppler imaging detects early myocardial dysfunction in asymptomatic patients with severe MR. Heart 2004;90(4):406-10.
  • Sahn DJ, De Maria A, Kisslo J, Weyman A. The committee on M-mode standardization of results of a survey of echocardiographic measurements. Circulation 1978;58:1072-1083
  • Harvey Feigenbaum. Ecocardiyography. 5th ed. India Lea & Febiger 1994.
  • Tei C, Ling LH, Hodge DO et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function--a study in normals and dilated cardiomyopathy. J Cardiol 1995;26(6):357-66.
  • Rocha P, Freitas S, Alvares S. Rheumatic fever--a review of cases. Rev Port Cardiol 2000;19(9):921-8.
  • Samer J. Khouri, MD, George T. Maly, MD. A practical approach to the echocardiographic evaluation of diastolic function. J Am Soc Echocardiogr 2004; 17:290-7.
  • Christian Bruch, MD, Rainer G, MD et al. Doppler tissue analysis of annular velocities: Evidence for systolic abnormalities in patients with diastolic heart failure. J Am Soc Echocardiogr 2003;16. 1031-6
  • T. H. Marwick. Clinical applications of tissue Doppler imaging: a promise fulfilled. Heart 2003;89:1377-78
  • Bart W. L. De Boeck. MD, Marten-Jan M. Cramer, MD et al. Spectral pulsed tissue Doppler imaging in diastole: A tool to increase our insight in and assessment of diastolic relaxation of the left ventricle. Am Heart J 2003; 146:411-9
  • Nazli C, Ozan K, Ergene O, Yavuz T, Gedikli O, Yesimcan H, Özaydın M, Altınbas A, DoganA, Kahraman H. Use of tissue Doppler echocardiography in early detection of left ventrikülersystolic dysfunction in patients with MR. The International Journal ofCardiovascular Imaging 2003; 19:199-209
  • T. H. Marwick. Clinical applications of tissue Doppler imaging: a promise fulfilled. Heart 2003;89:1377-78
  • Benjamin W. Eidem, MD, Colin J. McMahon, MBBCh, Radha R. Cohen, MD et al. Impact ofcardiac growth on Doppler tissue imaging velocities: A study in healthy children. J Am SocEchocardiogr 2004; 17:212-21
  • Colin J: McMahon, MB, MRCPI; Sherif F. Nagueh, MD, Ricardo H. Pignatelli et al.Chateterization of left ventricular diastolic function by tissue Doppler imaging and clinical statusin children with hypertrophic cardiomyopathy. Circulation 2004; 109:1756-62

Romatizmal mitral yetmezlikli çocuklarda geleneksel ekokardiyografi ve doku Doppler görüntüleme ile sol ventrikül fonksiyonlarının değerlendirilmesi

Year 2018, Volume: 8 Issue: 1, 1 - 6, 17.04.2018
https://doi.org/10.16899/gopctd.369657

Abstract



Amaç:  Romatizmal kardit tanısı ile izlenen mitral yetmezlikli çocuklarda sol ventrikül fonksiyonlarını geleneksel ekokardiyografi ve doku Doppler görüntü-
leme yöntemiyle değerlendirip, sonuçları sağlıklı kontrol grubu ile karşılaştırmayı amaçladık.
Gereç ve Yöntem: Pediatrik kardiyoloji kliniğimizde romatizmal kardit sonrası mitral yetmezlik tanısı ile izlenen 30 hasta ve 5-15 yaşları arasında 30 sağlıklı 
çocuk çalışmaya dahil edildi. Hasta grubu hafif-orta dereceli mitral yetmezlik ve ağır mitral yetmezlik olarak sınıflandırıldı. Tüm ekokardiyografik ölçümler ça-
lışma grubunun klinik ve laboratuvar sonuçlarına kör olan uzman bir pediatrik kardiyolog tarafından yapıldı.
Bulgular: Ağır mitral yetmezlikli hastalarda sol ventrikül diyastol sonu çapları kontrol grubuna göre anlamlı derecede artış gösterdi (4.62±0.82 cm, 3.92±0.39 
cm; p=0.008). Yine sol ventrikül sistol sonu çaplarında ağır mitral yetmezlikli hastalarda kontrol grubuna göre anlamlı olarak artmış bulundu (2.81±0.51,
2.43±0.25, p=0.01). Ejeksiyon fraksiyonu ve fraksiyonel kısalma açısından gruplar arasında istatistiksel olarak anlamlı fark yoktu (p>0.05). Doku Doppler görün-
tüleme yöntemiyle ölçülen erken diyastolik pik miyokard hızı gruplar arasında istatistiksel olarak anlamlı farklılık göstermediği halde (p>0.05), atriyal pik sisto-
lik hız, ağır mitral yetmezlikli hastalarda, hem kontrol hem de hafif-orta mitral yetmezlikli hastalara göre anlamlı derecede yüksek ölçüldü (sırasıyla p<0.001,
p=0.001).
Sonuç: Çalışmamızda, geleneksel ekokardiyografik ölçümlerle elde edilen sol ventrikül sistolik ve diyastolik fonksiyonları açısından kontrol grubu ile mitral 
yetmezlikli hasta grupları arasında istatistiksel olarak anlamlı bir farklılık bulunamamıştır. Buna rağmen mitral yetmezlikli hasta grubunda sol ventriküler
fonksiyonlardaki subklinik bozulma doku Doppler görüntüleme yöntemiyle saptanmıştır.

References

  • Gewitz MH, Baltimore RS, Tani LY etal. American Heart Association Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: a scientific statement from the American Heart Association. Circulation 2015;131(20):1806-18.
  • Myung K. Park. Pediatric cardiology for Practitioners. 4th ed. San Antorino: Texas; 2002.
  • Fujikawa S. Guidelines for the diagnosis of rheumatic fever: Jones criteria, updated 1992. Ryumachi 1993;33(5):451-5.
  • Enriquez-Sarano M, Tajik A, Schaff H, et al. Echocardiographic prediction of left ventricular function after correction of MR: results and clinical implications. J Am Coll Cardiol 1994;24:1536–43.
  • Polat TB, Yalcin Y, Erdem A, Zeybek C, Akdeniz C, Celebi A. Tissue Doppler imaging in rheumatic carditis. Cardiol Young. 2014 Apr;24(2):359-65.
  • Nazli C, Kinay O, Ergene O et al. Use of tissue Doppler echocardiography in early detection of left ventricular systolic dysfunction in patients with MR. Int J Cardiovasc Imaging 2003;19(3):199-209.
  • Isaaz K, Thompson A, Ethevenot G, Cloez JL, Brembilla B, Pernot C. Doppler echocardiographic measurement of low velocity motion of the left ventricular posterior wall. Am J Cardiol 1989;64(1):66-75.
  • Mc Dicken WN, Sutherland GR, Moran CM, Gordon L. Colour Doppler velocity imaging of the myocardium. Ultrasound Med Biol 1992;18:651-4
  • Agricola E, Galderisi M, Oppizzi M et al. Pulsed tissue Doppler imaging detects early myocardial dysfunction in asymptomatic patients with severe MR. Heart 2004;90(4):406-10.
  • Sahn DJ, De Maria A, Kisslo J, Weyman A. The committee on M-mode standardization of results of a survey of echocardiographic measurements. Circulation 1978;58:1072-1083
  • Harvey Feigenbaum. Ecocardiyography. 5th ed. India Lea & Febiger 1994.
  • Tei C, Ling LH, Hodge DO et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function--a study in normals and dilated cardiomyopathy. J Cardiol 1995;26(6):357-66.
  • Rocha P, Freitas S, Alvares S. Rheumatic fever--a review of cases. Rev Port Cardiol 2000;19(9):921-8.
  • Samer J. Khouri, MD, George T. Maly, MD. A practical approach to the echocardiographic evaluation of diastolic function. J Am Soc Echocardiogr 2004; 17:290-7.
  • Christian Bruch, MD, Rainer G, MD et al. Doppler tissue analysis of annular velocities: Evidence for systolic abnormalities in patients with diastolic heart failure. J Am Soc Echocardiogr 2003;16. 1031-6
  • T. H. Marwick. Clinical applications of tissue Doppler imaging: a promise fulfilled. Heart 2003;89:1377-78
  • Bart W. L. De Boeck. MD, Marten-Jan M. Cramer, MD et al. Spectral pulsed tissue Doppler imaging in diastole: A tool to increase our insight in and assessment of diastolic relaxation of the left ventricle. Am Heart J 2003; 146:411-9
  • Nazli C, Ozan K, Ergene O, Yavuz T, Gedikli O, Yesimcan H, Özaydın M, Altınbas A, DoganA, Kahraman H. Use of tissue Doppler echocardiography in early detection of left ventrikülersystolic dysfunction in patients with MR. The International Journal ofCardiovascular Imaging 2003; 19:199-209
  • T. H. Marwick. Clinical applications of tissue Doppler imaging: a promise fulfilled. Heart 2003;89:1377-78
  • Benjamin W. Eidem, MD, Colin J. McMahon, MBBCh, Radha R. Cohen, MD et al. Impact ofcardiac growth on Doppler tissue imaging velocities: A study in healthy children. J Am SocEchocardiogr 2004; 17:212-21
  • Colin J: McMahon, MB, MRCPI; Sherif F. Nagueh, MD, Ricardo H. Pignatelli et al.Chateterization of left ventricular diastolic function by tissue Doppler imaging and clinical statusin children with hypertrophic cardiomyopathy. Circulation 2004; 109:1756-62
There are 21 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Abdullah Yazar

Sevim Kararslan This is me

Publication Date April 17, 2018
Acceptance Date January 6, 2018
Published in Issue Year 2018 Volume: 8 Issue: 1

Cite

APA Yazar, A., & Kararslan, S. (2018). Evaluation of left ventricular functions by conventional echocardiography and tissue Doppler imaging in children with rheumatic valve disease. Çağdaş Tıp Dergisi, 8(1), 1-6. https://doi.org/10.16899/gopctd.369657
AMA Yazar A, Kararslan S. Evaluation of left ventricular functions by conventional echocardiography and tissue Doppler imaging in children with rheumatic valve disease. J Contemp Med. March 2018;8(1):1-6. doi:10.16899/gopctd.369657
Chicago Yazar, Abdullah, and Sevim Kararslan. “Evaluation of Left Ventricular Functions by Conventional Echocardiography and Tissue Doppler Imaging in Children With Rheumatic Valve Disease”. Çağdaş Tıp Dergisi 8, no. 1 (March 2018): 1-6. https://doi.org/10.16899/gopctd.369657.
EndNote Yazar A, Kararslan S (March 1, 2018) Evaluation of left ventricular functions by conventional echocardiography and tissue Doppler imaging in children with rheumatic valve disease. Çağdaş Tıp Dergisi 8 1 1–6.
IEEE A. Yazar and S. Kararslan, “Evaluation of left ventricular functions by conventional echocardiography and tissue Doppler imaging in children with rheumatic valve disease”, J Contemp Med, vol. 8, no. 1, pp. 1–6, 2018, doi: 10.16899/gopctd.369657.
ISNAD Yazar, Abdullah - Kararslan, Sevim. “Evaluation of Left Ventricular Functions by Conventional Echocardiography and Tissue Doppler Imaging in Children With Rheumatic Valve Disease”. Çağdaş Tıp Dergisi 8/1 (March 2018), 1-6. https://doi.org/10.16899/gopctd.369657.
JAMA Yazar A, Kararslan S. Evaluation of left ventricular functions by conventional echocardiography and tissue Doppler imaging in children with rheumatic valve disease. J Contemp Med. 2018;8:1–6.
MLA Yazar, Abdullah and Sevim Kararslan. “Evaluation of Left Ventricular Functions by Conventional Echocardiography and Tissue Doppler Imaging in Children With Rheumatic Valve Disease”. Çağdaş Tıp Dergisi, vol. 8, no. 1, 2018, pp. 1-6, doi:10.16899/gopctd.369657.
Vancouver Yazar A, Kararslan S. Evaluation of left ventricular functions by conventional echocardiography and tissue Doppler imaging in children with rheumatic valve disease. J Contemp Med. 2018;8(1):1-6.