Myocardial Tissue Doppler Changes in Patients with Bronchopulmonary Dysplasia

Yates, Andrew R.; Welty, Stephen E.; Gest, Alfred L.; Cua, Clifford L.

doi:10.1016/j.jpeds.2007.11.039

« Previous Next »The Journal of Pediatrics
Volume 152, Issue 6 , Pages 766-770.e1, June 2008

Myocardial Tissue Doppler Changes in Patients with Bronchopulmonary Dysplasia

Presented at the 2007 meeting of the Pediatric Academic Societies, May 5–8, Toronto, Ontario, Canada, and the Cardiology 2007—10th Annual Update on Pediatric Cardiovascular Disease, February 21–25, Orlando, Florida.

Andrew R. Yates, MD
- Department of Pediatrics, Ohio State University, Columbus, Ohio
- Columbus Children's Hospital Heart Center and Columbus Children's Research Institute Center of Cardiovascular Medicine, Columbus Ohio
- Reprint requests: Andrew R. Yates, MD, Cardiology Fellow, Columbus Children's Hospital Heart Center, 700 Children's Dr, Columbus, OH 43205.
Stephen E. Welty, MD
- Department of Pediatrics, Ohio State University, Columbus, Ohio
- Columbus Children's Hospital Division of Neonatology and Columbus Children's Research Institute Center of Perinatal Research, Columbus, OH.
Alfred L. Gest, MD
- Department of Pediatrics, Ohio State University, Columbus, Ohio
- Columbus Children's Hospital Division of Neonatology and Columbus Children's Research Institute Center of Perinatal Research, Columbus, OH.
Clifford L. Cua, MD
- Department of Pediatrics, Ohio State University, Columbus, Ohio
- Columbus Children's Hospital Heart Center and Columbus Children's Research Institute Center of Cardiovascular Medicine, Columbus Ohio

Received 25 May 2007; received in revised form 24 October 2007; accepted 28 November 2007. published online 13 February 2008.

Objective

To determine whether tissue Doppler measurements provide sensitive measures of right ventricular function that correlate with the severity of bronchopulmonary dysplasia (BPD).

Study design

21 subjects (6 control subjects with no/mild BPD, 7 patients with moderate BPD, and 8 patients with severe BPD) underwent limited echocardiograms with standard M-mode, mitral and tricuspid inflow velocities, and tissue Doppler features measured. BPD severity was scored by using the NICHD/NHLBI/ORD workshop rating scale by physicians blinded to the echocardiogram results. Groups were compared by using 1-way analysis of variance with post-hoc testing and linear regression.

Results

Patients with moderate BPD had a higher early Doppler inflow velocity to the early tissue Doppler velocity ratio (E/E′ ratio; P = .03), corresponding to increased end diastolic pressure, compared with patients with no/mild BPD. Patients with severe BPD had a higher E/E′ ratio (P = .004) than patients with no/mild BPD. Linear regression demonstrated a correlation between BPD category and right ventricle E/E′ (P = .007, R² = 0.33) and left ventricular myocardial performance index (P = .02, R² = 0.28).

Conclusion

Increasing right ventricle E/E′ ratio correlates with clinical severity of BPD. Abnormal left ventricular myocardial performance index was noted to correlate with the grade of BPD. Further longitudinal studies of tissue Doppler echocardiographic assessment of cardiac function in premature infants with BPD are needed.

Abbreviations: A, Late diastolic blood inflow velocity, A′, Tissue Doppler late diastolic wave velocity, BPD, Bronchopulmonary dysplasia, E, Early diastolic blood inflow velocity, E′, Tissue Doppler early diastolic wave velocity, E/E′, Early Doppler inflow velocity to the early tissue Doppler velocity ratio, ICT, Isovolemic contraction time, IRT, Isovolemic relaxation time, LV, Left ventricle, LVH, Left ventricular hypertrophy, MPI, Myocardial performance index, RV, Right ventricle, S′, Tissue Doppler systolic wave velocity