January 1, 2009Circulation JournalOpen Access

Relationship of Maximum Rate of Pressure Rise Between Aorta and Left Ventricle in Pediatric Patients Implication for Ventricular-Vascular Interaction With the Potential for Noninvasive Determination of Left Ventricular Contractility

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Why the study?

Can left ventricular contractility (LV dp/dtmax) be accurately estimated from the maximum rate of aortic pressure rise (Ao dp/dtmax) in pediatric patients?

Population

75 pediatric patients undergoing diagnostic/interventional cardiac catheterization, including 30 control…

Design

Cross-sectional

Authors

SMSatoshi MasutaniSaitama Medical University YIYoichi IwamotoSocial Insurance Saitama Chuo Hospital HIHirotaka IshidoSaitama Medical University

Discussion

Member takes

Implication

May support noninvasive pediatric LV contractility estimation; leaves open prospective validation before clinical use.

Structured PICO

Can left ventricular contractility (LV dp/dtmax) be accurately estimated from the maximum rate of aortic pressure rise (Ao dp/dtmax) in pediatric patients?

Population

75 pediatric patients undergoing diagnostic/interventional cardiac catheterization, including 30 control children (recovered from Kawasaki disease with normal coronary angiography) and 45 patients with various cardiovascular diseases (e.g., ASD, VSD, postoperative states).

Intervention

Estimation of left ventricular (LV) dp/dtmax from aortic (Ao) dp/dtmax and vascular loading properties (characteristic impedance and mean arterial pressure).

Outcome

Correlation between invasively measured LV dp/dtmax and estimated LV dp/dtmax derived from Ao dp/dtmax.surrogate

The maximum rate of left ventricular pressure rise (LV dp/dtmax) can be accurately estimated from the aortic pressure rise (Ao dp/dtmax) and vascular loading properties, offering a potential noninvasive method to assess LV contractility in pediatric patients.

Limitations

Kawasaki disease patients used as controls may not be truly normal.
Remains to be validated with noninvasive Ao dp/dtmax (e.g., tonometry).
Limited number of patients and biased diagnoses.
Could not test acute change in afterload for ethical reasons.
Method estimates LV dp/dtmax utilizing afterload data, so it is not a direct alternative to afterload-independent LV dp/dtmax.

Cite This Study

Masutani et al. (2009) studied this question.

synapsesocial.com/papers/6a6fc07df44fa9f079dd3d47 https://doi.org/10.1253/circj.cj-08-0954

Topics

Congenital heart disease adults

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Relationship of Maximum Rate of Pressure Rise Between Aorta and Left Ventricle in Pediatric Patients Implication for Ventricular-Vascular Interaction With the Potential for Noninvasive Determination of Left Ventricular Contractility

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Topics

Relationship of Maximum Rate of Pressure Rise Between Aorta and Left Ventricle in Pediatric Patients Implication for Ventricular-Vascular Interaction With the Potential for Noninvasive Determination of Left Ventricular Contractility

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

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