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Iranian Journal of Pediatrics
Tehran University of Medical Sciences Press
ISSN: 1018-4406
EISSN: 2008-2150
Vol. 19, No. 3, 2009, pp. 224-230
Bioline Code: pe09034
Full paper language: English
Document type: Research Article
Document available free of charge

Iranian Journal of Pediatrics, Vol. 19, No. 3, 2009, pp. 224-230

 en Relation of Mean Right Atrial Pressure to Doppler Parameters of Right Atrial and Hepatic Venous Flow in Pediatric Patients with Congenital Heart Disease
Amoozgar, Hamid; Zare, Khobiar; Borzoee, Mohammad; Ajami, Gholamhossein & Abtahi, Saeid

Abstract

Objective: A paucity of data exists regarding the relation of mean right atrial pressure (RAP) to Doppler parameters of right atrial and ventricular filling in pediatric patients with congenital heart disease.
Methods: Fifty patients (30 male and 20 female) with mean age of 4.96±4.05 who were admitted in the pediatric cardiology ward of Nemazee Hospital affiliated to Shiraz University of Medical Sciences, were included in this study. Patients were categorized into two groups according to their RAP measured by cardiac catheterization: Group 1 (40 patients) were those with mean RAP <8 mmHg and group 2 (10 patients) who had mean RAP ≥8 mmHg. Data gathered from hepatic venous flow, tricuspid diastolic flow and pulse tissue Doppler of lateral tricuspid annulus of each patient were then compared with right atrial pressure obtained by cardiac catheterization.
Findings: If change of peak S wave velocity of hepatic vein in respiration was more than 38%, sensitivity and specificity of a RAP more than 8 mmHg was 90% and 51.3% respectively with likelihood ratio (LR) equal to 1.85; a peak S wave velocity of less than 70 mm/sec also showed a RAP more than 8 mmHg with sensitivity and specificity of 70 and 82.1 respectively (LR=3.9). A peak expiratory D wave velocity of hepatic vein more than 63 mm/sec was indicator of RAP more than 8 mmHg with sensitivity and specificity of 60% and 92.3% respectively (LR=7.8).
Conclusion: This study showed that hepatic venous flow can be valuable for estimation of mean RAP in pediatric patients with congenital heart disease.

Keywords
Diastole, Echocardiography, Ventricles, Pressure, Atrium

 
© © 2009 by Center of Excellence for Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences,All rights reserved.
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