Novel echocardiographic markers for the assessment of pulmonary hypertension in infants
摘要
Pulmonary hypertension (PH) confers significant morbidity and mortality in infants. Risk limits utilization of cardiac catheterization for diagnosis. Pulmonary-artery-acceleration-time (PAAT) and eccentricity-index (EI) are echocardiographically-measured surrogates in adults but data in infants is limited.
ObjectiveEvaluate the association of PAAT and EI with catheterization-derived hemodynamic measurements in infants without structural heart disease.
MethodsThis retrospective review included 30 cardiac catheterization studies performed in infants. Echocardiograms performed within one month of catheterization were reviewed. Multiple linear regression and agreement analyses were conducted between catheterization and echocardiographic data for the presence and severity of PH.
ResultsPAAT was significantly associated with mean pulmonary artery pressure (r-square = 0.34, p < 0.003) and pulmonary vascular resistance (r-square = 0.21, p < 0.039). EI was not associated. Agreement of severity of PH by echocardiographic and catheterization data was fair (kappa = 0.29).
ConclusionsIn infants, PAAT is associated with invasive hemodynamic measurements, while EI is not associated. These measures do not improve upon other echocardiogram-derived estimates of PH.