Why the study?
The study aimed to use RT-3DE to evaluate changes in biventricular volume and systolic function before surgery in children with VSD and moderate to severe pulmonary hypertension.
Does real-time three-dimensional echocardiography detect changes in biventricular volume and systolic function in children with VSD and moderate to severe PH compared to healthy controls?
Does real-time three-dimensional echocardiography detect changes in biventricular volume and systolic function in children with VSD and moderate to severe PH compared to healthy controls?
RT-3DE demonstrates increased biventricular volume and decreased systolic function in children with VSD and moderate to severe PH, though systolic function remains within acceptable limits for surgery.
Answers are grounded in this paper and cite their sources.
RT-3DE may quantify biventricular changes preoperatively in pediatric VSD with PH; leaves open its role in risk stratification or timing.
Background: Real-time three-dimensional echocardiography (RT-3DE) could obtain ventricular volume and ejection fraction rapidly and non-invasively without relying on ventricular morphology. This study aims to use RT-3DE to evaluate the changes in biventricular volume and systolic function in children with ventricular septal defect (VSD) and moderate to severe pulmonary hypertension (PH) before surgery. Methods: In this study 18 children with VSD and moderate to severe PH (VSD + PH Group) and 18 healthy children of the same age (Control Group) were recruited. Biventricular volume and systolic function were evaluated by RT-3DE. The measurements included: left and right ventricular volume indexed to body surface area (BSA), stroke volume (SV) indexed to BSA, and ejection fraction (EF). Results: The results showed left and right ventricular volume indexed to BSA and SV indexed to BSA were significantly increased in VSD + PH Group (VSD + PH Group vs. Control Group), LVEDV/BSA (ml/m2 ): 48.67 ± 21.46 vs. 25.59 ± 6.96, RVEDV/BSA (ml/m2 ): 55.98 ± 15.35 vs. 27.69 ± 4.37, LVSV/BSA (ml/m2 ): 24.08 ± 9.30 vs. 15.14 ± 4.29, RVSV/BSA (ml/m2 ): 26.02 ± 8.87 vs. 14.11 ± 2.89, (P < 0.05). While for EF in VSD + PH Group decreased (VSD + PH Group vs. Control Group), LVEF: 50.93 ± 7.50% vs. 59.38 ± 7.24%, RVEF: 45.84 ± 7.71% vs. 51.05 ± 6.90% (P < 0.05). Conclusion: In children with VSD and moderate to severe PH, increased biventricular volume and decreased systolic function were observed with RT-3DE, but biventricular systolic function remained within acceptable limits. The children in this study recovered well after surgery without serious perioperative complications, suggesting that biventricular systolic function may help facilitate the surgical decision-making process in children with VSD and moderate-tosevere PH.
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Zhou et al. (2022) studied this question.
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