Left Ventricular End-Systolic Eccentricity Index for Assessment of Pulmonary Hypertension in Infants
Abraham, Sharon and Weismann, Constance G LU
(2016)
In Echocardiography
33(6).
p.5-910
- Abstract
BACKGROUND: Pulmonary hypertension (PH) is a common problem in the neonatal intensive care unit and is associated with significant morbidity and mortality. The aim of this study was to identify a quantitative echocardiographic marker of septal curvature that can be used to accurately identify PH in NICU infants with concern for PH.
METHODS: Echocardiograms of infants who were prematurely born and infants with persistent pulmonary hypertension of the newborn were performed using a defined protocol for evaluation of PH. Qualitative assessment by a single pediatric cardiologist was used as a reference standard. Qualitative and quantitative parameters of right ventricular (RV) size, pressure, and function were documented. Left... (More)
BACKGROUND: Pulmonary hypertension (PH) is a common problem in the neonatal intensive care unit and is associated with significant morbidity and mortality. The aim of this study was to identify a quantitative echocardiographic marker of septal curvature that can be used to accurately identify PH in NICU infants with concern for PH.
METHODS: Echocardiograms of infants who were prematurely born and infants with persistent pulmonary hypertension of the newborn were performed using a defined protocol for evaluation of PH. Qualitative assessment by a single pediatric cardiologist was used as a reference standard. Qualitative and quantitative parameters of right ventricular (RV) size, pressure, and function were documented. Left ventricular end-systolic eccentricity index (EI) was defined as the ratio of the anterior-inferior and septal-posterolateral cavity dimensions at the mid-ventricular level.
RESULTS: A total of 216 infants at risk for PH were included in this study. One hundred forty-three (66%) had an interpretable tricuspid regurgitation jet velocity. While systolic septal flattening was recognized at EIs ≥ 1.15, more than half-systemic RV pressure became apparent at EIs ≥ 1.3. Unlike qualitative assessment of septal flattening, there was high inter-observer agreement for EIs. Quantitative parameters of RV systolic function were impaired only at EIs ≥ 1.3.
CONCLUSIONS: We suggest that EIs should be incorporated into routine protocols when there is a concern for PH in neonates. This may lead to a more reliable assessment of PH and may reduce inter-observer variability. Correlation of EIs with invasive hemodynamic data is needed to validate our results.
(Less)
- author
- Abraham, Sharon
and Weismann, Constance G
LU
- publishing date
- 2016-06
- type
- Contribution to journal
- publication status
- published
- keywords
- Algorithms, Echocardiography/methods, Female, Humans, Hypertension, Pulmonary/complications, Image Enhancement/methods, Image Interpretation, Computer-Assisted/methods, Infant, Male, Reproducibility of Results, Sensitivity and Specificity, Stroke Volume, Ventricular Dysfunction, Left/diagnostic imaging
- in
- Echocardiography
- volume
- 33
- issue
- 6
- pages
- 5 - 910
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:26773570
- scopus:84975251953
- ISSN
- 0742-2822
- DOI
- 10.1111/echo.13171
- language
- English
- LU publication?
- no
- id
- 36131fe0-1af1-4bf5-b124-28080021a2d8
- date added to LUP
- 2019-01-25 14:42:53
- date last changed
- 2024-06-12 06:05:27
@article{36131fe0-1af1-4bf5-b124-28080021a2d8,
abstract = {{<p>BACKGROUND: Pulmonary hypertension (PH) is a common problem in the neonatal intensive care unit and is associated with significant morbidity and mortality. The aim of this study was to identify a quantitative echocardiographic marker of septal curvature that can be used to accurately identify PH in NICU infants with concern for PH.</p><p>METHODS: Echocardiograms of infants who were prematurely born and infants with persistent pulmonary hypertension of the newborn were performed using a defined protocol for evaluation of PH. Qualitative assessment by a single pediatric cardiologist was used as a reference standard. Qualitative and quantitative parameters of right ventricular (RV) size, pressure, and function were documented. Left ventricular end-systolic eccentricity index (EI) was defined as the ratio of the anterior-inferior and septal-posterolateral cavity dimensions at the mid-ventricular level.</p><p>RESULTS: A total of 216 infants at risk for PH were included in this study. One hundred forty-three (66%) had an interpretable tricuspid regurgitation jet velocity. While systolic septal flattening was recognized at EIs ≥ 1.15, more than half-systemic RV pressure became apparent at EIs ≥ 1.3. Unlike qualitative assessment of septal flattening, there was high inter-observer agreement for EIs. Quantitative parameters of RV systolic function were impaired only at EIs ≥ 1.3.</p><p>CONCLUSIONS: We suggest that EIs should be incorporated into routine protocols when there is a concern for PH in neonates. This may lead to a more reliable assessment of PH and may reduce inter-observer variability. Correlation of EIs with invasive hemodynamic data is needed to validate our results.</p>}},
author = {{Abraham, Sharon and Weismann, Constance G}},
issn = {{0742-2822}},
keywords = {{Algorithms; Echocardiography/methods; Female; Humans; Hypertension, Pulmonary/complications; Image Enhancement/methods; Image Interpretation, Computer-Assisted/methods; Infant; Male; Reproducibility of Results; Sensitivity and Specificity; Stroke Volume; Ventricular Dysfunction, Left/diagnostic imaging}},
language = {{eng}},
number = {{6}},
pages = {{5--910}},
publisher = {{Wiley-Blackwell}},
series = {{Echocardiography}},
title = {{Left Ventricular End-Systolic Eccentricity Index for Assessment of Pulmonary Hypertension in Infants}},
url = {{http://dx.doi.org/10.1111/echo.13171}},
doi = {{10.1111/echo.13171}},
volume = {{33}},
year = {{2016}},
}