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Echocardiography in pediatric pulmonary hypertension.

Jone PN, Ivy DD - Front Pediatr (2014)

Bottom Line: Pulmonary hypertension (PH) can be a rapidly progressive and fatal disease.Although right heart catheterization remains the gold standard in evaluation of PH, echocardiography remains an important tool in screening, diagnosing, evaluating, and following these patients.In this article, we will review the important echocardiographic parameters of the right heart in evaluating its anatomy, hemodynamic assessment, systolic, and diastolic function in children with PH.

View Article: PubMed Central - PubMed

Affiliation: Pediatric Cardiology, Children's Hospital Colorado, University of Colorado School of Medicine , Aurora, CO , USA.

ABSTRACT
Pulmonary hypertension (PH) can be a rapidly progressive and fatal disease. Although right heart catheterization remains the gold standard in evaluation of PH, echocardiography remains an important tool in screening, diagnosing, evaluating, and following these patients. In this article, we will review the important echocardiographic parameters of the right heart in evaluating its anatomy, hemodynamic assessment, systolic, and diastolic function in children with PH.

No MeSH data available.


Related in: MedlinePlus

Measurement of tricuspid annular plane systolic excursion (TAPSE) from M-mode in the apical four-chamber view at the level of the tricuspid annulus in a patient with pulmonary hypertension.
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Figure 11: Measurement of tricuspid annular plane systolic excursion (TAPSE) from M-mode in the apical four-chamber view at the level of the tricuspid annulus in a patient with pulmonary hypertension.

Mentions: The longitudinal fibers are the major contributor to RV systolic function. Tricuspid annular plane systolic excursion (TAPSE) is a method to measure the distance of systolic excursion of the RV annular segment along its longitudinal plane from the apical four chamber view in millimeters from end-diastole to end-systole. The greater the descent of the basal annulus in systole, the better RV systolic function is. TAPSE is usually acquired by placing the M-mode cursor through the lateral tricuspid annulus and measuring the amount of longitudinal motion of the annulus in peak systole (Figure 11). TAPSE < 18 mm has been demonstrated in adult patients with PH to be associated with greater RV systolic dysfunction and lower survival rate (66). There is also a strong correlation between TAPSE and reduced RV FAC regardless of pulmonary artery pressures in adults (67). Normal values for TAPSE in children have been published and z-scores established (68). Children with idiopathic PAH who had TAPSE z-score <−4.3 were associated with increased risk of transplant or death (6). The advantage of using TAPSE is that it is a simple and reproducible measure but it is important to note that TAPSE is angle and load dependent. TAPSE is also one-dimensional and does not take into the account the three-dimensional structure of the RV. TAPSE does not evaluate apical systolic dysfunction in patients with PH.


Echocardiography in pediatric pulmonary hypertension.

Jone PN, Ivy DD - Front Pediatr (2014)

Measurement of tricuspid annular plane systolic excursion (TAPSE) from M-mode in the apical four-chamber view at the level of the tricuspid annulus in a patient with pulmonary hypertension.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4228850&req=5

Figure 11: Measurement of tricuspid annular plane systolic excursion (TAPSE) from M-mode in the apical four-chamber view at the level of the tricuspid annulus in a patient with pulmonary hypertension.
Mentions: The longitudinal fibers are the major contributor to RV systolic function. Tricuspid annular plane systolic excursion (TAPSE) is a method to measure the distance of systolic excursion of the RV annular segment along its longitudinal plane from the apical four chamber view in millimeters from end-diastole to end-systole. The greater the descent of the basal annulus in systole, the better RV systolic function is. TAPSE is usually acquired by placing the M-mode cursor through the lateral tricuspid annulus and measuring the amount of longitudinal motion of the annulus in peak systole (Figure 11). TAPSE < 18 mm has been demonstrated in adult patients with PH to be associated with greater RV systolic dysfunction and lower survival rate (66). There is also a strong correlation between TAPSE and reduced RV FAC regardless of pulmonary artery pressures in adults (67). Normal values for TAPSE in children have been published and z-scores established (68). Children with idiopathic PAH who had TAPSE z-score <−4.3 were associated with increased risk of transplant or death (6). The advantage of using TAPSE is that it is a simple and reproducible measure but it is important to note that TAPSE is angle and load dependent. TAPSE is also one-dimensional and does not take into the account the three-dimensional structure of the RV. TAPSE does not evaluate apical systolic dysfunction in patients with PH.

Bottom Line: Pulmonary hypertension (PH) can be a rapidly progressive and fatal disease.Although right heart catheterization remains the gold standard in evaluation of PH, echocardiography remains an important tool in screening, diagnosing, evaluating, and following these patients.In this article, we will review the important echocardiographic parameters of the right heart in evaluating its anatomy, hemodynamic assessment, systolic, and diastolic function in children with PH.

View Article: PubMed Central - PubMed

Affiliation: Pediatric Cardiology, Children's Hospital Colorado, University of Colorado School of Medicine , Aurora, CO , USA.

ABSTRACT
Pulmonary hypertension (PH) can be a rapidly progressive and fatal disease. Although right heart catheterization remains the gold standard in evaluation of PH, echocardiography remains an important tool in screening, diagnosing, evaluating, and following these patients. In this article, we will review the important echocardiographic parameters of the right heart in evaluating its anatomy, hemodynamic assessment, systolic, and diastolic function in children with PH.

No MeSH data available.


Related in: MedlinePlus