Tissue Doppler Combined with Pulsed-Wave Doppler Echocardiography for Evaluating Ventricular Diastolic Function in Normal Children

BACKGROUND: The ratio of the peak transmitral velocity during early diastole (E) to the peak mitral valve annular velocity during early diastole (E') obtained by tissue Doppler imaging correlates with the left ventricular end-diastolic pressure in adults. However, the E/E' ratio has not been established in normal children. The purpose of this study was to assess the effect of age on the various tissue Doppler indices of ventricular diastolic function. METHODS: The subjects in this study included 174 children with normal cardiac function. The left and right ventricular inflow velocities were recorded, and the peak of late diastolic flow velocities (A), E, and the ratio of E/A were determined. The following tissue Doppler indices were obtained: peak velocities of early and late diastolic mitral annulus in the left ventricular lateral wall (E'l and A'l) and in the interventricular septum (E'se and A'se) and those of the lateral tricuspid annulus in the right ventricle, E'r and A'r. RESULTS: The E'l and the E'se increased with age up to 5 years after birth, after which they became constant. The E'r was constant after birth. The E'l/A'l and E'se/A'se increased with age up to 5 years after birth, after which they became constant. The E'r/A'r was constant after birth. The Em/E'se and Em/E'l decreased with age up to 5 years after birth, after which they became constant. The Et/E'r was constant after birth. CONCLUSION: The age-related changes suggest age-related alterations in left ventricular diastolic function. Right ventricular diastolic function is constant after birth.