Korean J Pediatr.  2007 May;50(5):476-483. 10.3345/kjp.2007.50.5.476.

Evaluation of short-term cardiac function by tissue Doppler imaging in pre and postoperative period of congenital heart disease

• Lee JH
• Kim YH
• Hyun MC
• Lee SB

• KMID: 2072885
• DOI: http://doi.org/10.3345/kjp.2007.50.5.476

Abstract

PURPOSE: The objective of this study was to assess ventricular function by tissue Doppler imaging (TDI) in children with congenital heart disease (CHD) who have been undergoing open heart surgery (OHS) using cardiopulmonary bypass. We tried to compare the parameters of tissue Doppler imaging before and after OHS in patients with congenital heart disease.
METHODS
This study was conducted on 32 patients with CHD after OHS from January 2005 to December 2005 at Kyungpook National University hospital. Patients who underwent 2-D echocardiography before and after their OHS. All patients were divided into three groups, left ventricular volume overloading group (group 1), and right ventricular volume overloading group (group 2), and right ventricular pressure overloading group (group 3). The TDIs were examined before and 1 to 3 months after OHS. Peak early diastolic (E), and peak late diastolic (A) velocity of transmitral flow were measured by pulsed wave Doppler examination. Peak systolic (Sm), peak early diastolic (Em), and peak late diastolic (Am) velocity in apical 4-chamber and 2-chamber views were measured by TDI. The author calculated E/Em ratio.
RESULTS
The patients were 14 boys and 18 girls and the average age of patients was 2 years and 3 months. The congenital heart diseases which have to get OHS were ventricular septal defect (13 cases), atrial septal defect (7), atrioventricular septal defect (3), isolated pulmonary stenosis (2) and tetralogy of Fallot (7). There were significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view (P<0.05).
CONCLUSION
This study showed significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view after OHS. These changes might be due to the effects of cardiopulmonary bypass in OHS and/or hemodynamic changes after correction of congenital heart disease. To clarify these changes, further study on more patients is needed.

Keyword

Congenital heart disease; Heart surgery; Doppler echocardiography; Ventricular function

MeSH Terms

Cardiopulmonary Bypass
Child
Echocardiography
Echocardiography, Doppler
Female
Gyeongsangbuk-do
Heart Defects, Congenital*
Heart Diseases
Heart Septal Defects, Atrial
Heart Septal Defects, Ventricular
Hemodynamics
Humans
Postoperative Period*
Pulmonary Valve Stenosis
Tetralogy of Fallot
Thoracic Surgery
Ventricular Function
Ventricular Pressure