DIASTOLIC VENTRICULAR-FUNCTION IN CHILDREN - A DOPPLER-ECHOCARDIOGRAPHIC STUDY ESTABLISHING NORMAL VALUES AND PREDICTORS OF INCREASED VENTRICULAR END-DIASTOLIC PRESSURE

Objective: To extend noninvasive assessment of diastolic cardiac funct ion into the pediatric age-group. Design: This study was divided into two phases, the first of which was designed to provide an age-appropri ate set of normal diastolic Doppler echocardiographic data for childre n and adolescents and the second of which was to determine whether the se Doppler techniques could be used to identify children with increase d ventricular end-diastolic pressure (EDP), Material and Methods: Comp lete echocardiographic studies focusing on Doppler variables of diasto lic ventricu lar function were performed on 223 normal children. Value s observed were analyzed for dependence on age, heart rate, and gender , Results from the normal group were then compared with Doppler values observed in a group of 24 children with catheterization-substantiated increases in ventricular EDP, Results: Normal values for the Doppler factors studied vary with both age and heart rate. The variables that most confidently distinguished children with increased EDP from normal subjects were the ratio of and the difference between the durations o f pulmonary vein atrial reversal and the mitral A wave. A ratio of 1.2 or more or a difference of 29 ms or more identified those children wi th increased EDP with sensitivities of 88 and 90% and specificities of 86 and 86%, respectively. Conclusion: Use of the normal data and the Doppler techniques described in this study will allow confident assess ment of diastolic function in children as well as in adults.