Author + information
- Jeremy Zuckerberg,
- Michael Quartermain,
- Stanford Ewing and
- Anirban Banerjee
Background: Guidelines for evaluating left ventricular (LV) diastolic dysfunction in adults, often do not apply in children. We hypothesize left atrial (LA) stiffness may serve as a noninvasive surrogate of LV diastolic dysfunction in children with cardiomyopathy (CMP).
Methods: We studied 41 CMP patients (ages 0.4-18yrs) with dilated (n=21), hypertrophic (n=13) and restrictive (n=7) types. These CMP patients also had elevated PCWP >13mmHg noted at cardiac catheterization. Patients with normal PCWP (<12mmHg), who underwent catheterization for small patent ductus arteriosus (n=14), mild coarctation (n=9), pulmonary stenosis (n=8) or Kawasaki disease (n=3) with no LV hypertrophy or dilatation and normal LV function, served as controls (ages 0.5-22yrs). LA peak strain was measured by speckle tracking echocardiography and E/e’ recorded from apical 4-chamber views. LA stiffness=E/e'÷Peak LA strain (%-1).
Results: In CMP group, PCWP was significantly higher (19.0±4.9 vs 8.9±2.0mmHg, p<0.01), LA strain was significantly decreased (16.9±12.0 vs 52.2±22.8%, p<0.01) and LA stiffness was significantly increased (1.4±1.3 vs 0.13±0.11%-1, p<0.01). From receiver operator characteristic curves, cutoff value for LA stiffness was 0.27%-1 (Fig. 1), sensitivity 100% & specificity 94%.
Conclusions: LA stiffness was significantly increased and yielded a distinct cutoff value in pediatric CMP with elevated PCWP. LA stiffness may serve as surrogate of elevated PCWP and LV diastolic dysfunction in children.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Congenital Heart Disease: New Diagnostic Approaches in Congenital Heart Disease
Abstract Category: 10. Congenital Heart Disease: Pediatric
Presentation Number: 1231-015
- 2017 American College of Cardiology Foundation