Key result
Children with pulmonary hypertension had significantly impaired tissue Doppler parameters vs controls, including higher mitral lateral MPI (median 0.73 vs 0.51, p=0.001) and lower TAPSE (p<0.001).
Why the study?
Do Tissue Doppler echocardiographic imaging parameters differ between children with pulmonary hypertension and healthy controls, and correlate with functional class, BNP levels, and exercise capacity?
Case-Control (n=77)
No
Do Tissue Doppler echocardiographic imaging parameters differ between children with pulmonary hypertension and healthy controls, and correlate with functional class, BNP levels, and exercise capacity?
Tissue Doppler imaging parameters—particularly mitral lateral MPI, tricuspid septal E/Ea, and interventricular septum MPI—are significantly impaired in children with pulmonary hypertension and correlate with NYHA class, 6MWT distance, and BNP levels, supporting their non-invasive utility in disease follow-up.
Tissue Doppler parameters may support non-invasive monitoring in pediatric pulmonary hypertension; hypothesis-generating before prospective outcome trials.
Akın A, Alehan D, Aykan HH, Özkutlu S, Özer S, Karagöz T. Evaluation of Tissue Doppler Echocardiographic Imaging findings in children with pulmonary hypertension. Turk J Pediatr 2017; 59: 244-253. Tissue Doppler Imaging has become an important prognostic marker that can be used in follow-up and determination of the prognosis in pulmonary hypertension patients. We compared the Tissue Doppler imaging parameters of 34 patients with pulmonary hypertension and 43 healthy controls. In addition, Brain-Natriuretic Peptide levels, pulmonary artery systolic pressures measured with echocardiography, 6-minute walking tests and New York Heart Association functional classification were compared. Among patients with Eisenmenger syndrome and idiopathic pulmonary hypertension, Tissue Doppler imaging parameters were mostly similar. In patients with New York Heart Association functional class 3, mitral septal annulus E/Ea (p=0.050) and mitral lateral annulus myocardial performance index (p=0.009) were higher than class 2 patients. In patients with higher Brain Natriuretic Peptide level, mitral lateral annulus and tricuspid septal annulus Ea/Aa values were lower (p=0.046 and < 0.001 respectively); tricuspid septal annulus E/Ea and interventricular septum myocardial performance index values were higher than in patients with normal Brain-Natriuretic Peptide level (p=0.006). In conclusion tissue Doppler imaging findings were significantly impaired in children with pulmonary hypertension compared to the control group. Findings were similar in patients with idiopathic pulmonary hypertension and Eisenmenger syndrome. Mitral lateral annulus myocardial performance index value may have a prognostic importance due its significant association with poor functional class. Due to the significant associations between mitral lateral annulus, tricuspid septal annulus Ea/Aa, tricuspid septal annulus Ea and E/Aa, interventricular septum-myocardial performance index values and brain natriuretic peptide levels, these parameters may be used in evaluating response to therapy.
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Akın et al. (2017) conducted a case-control in Pediatric irreversible pulmonary hypertension (idiopathic pulmonary hypertension and Eisenmenger syndrome) (n=77). Irreversible pulmonary hypertension evaluated by Tissue Doppler Imaging (TDI) vs. Healthy children with normal physical examination and echocardiography was evaluated on Mitral lateral annulus myocardial performance index (MPI) (p=0.001). Children with pulmonary hypertension had significantly impaired tissue Doppler parameters vs controls, including higher mitral lateral MPI (median 0.73 vs 0.51, p=0.001) and lower TAPSE (p<0.001).
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