Objective This study attempted to seek a new Doppler-derived index for estimating ventricularsystolic function. Methods With custom - made software the aortic and pulmonic flow profiles were digitized andconverted to ...Objective This study attempted to seek a new Doppler-derived index for estimating ventricularsystolic function. Methods With custom - made software the aortic and pulmonic flow profiles were digitized andconverted to their 4V2 curves, their maximum value of the first derivative, max (dk/dt) were obtained separately in23 and 25patients with congenital heart disease (mean age 4.5 years). Aortic max(dk/dt) and pulmonic max(dk/dt)measured by Doppler were compared with left ventricular max(dp/dt) and right ventricular max(dp/dt) measuredby cardiac catheterization. Results Aortic max(dk/dt) correlated well with LV max(dp/dt) (r=0.817, P<0.001).An excellent correlation of pulmonic max(dk/dt) with RV max(dp/dt) was established (r=0.926, P<0.0001). Therewas a significant correlation between RVSP and RV max(dp/dt) (r= 0.839, P<0.0001). Conclusion Doppler - derived aortic max(dk/dt) and pulmonic max(dk/dt) could be reliable index of left ventricular contractility and rightventricular contractility respectively. When max(dp/dt) is used for assessing RV systolic function, the impact ofRVSP on that should be taken into consideration.展开更多
Background Assessment of cardiac function is crucial in pediatric patients undergoing cardiovascular surgery, monitoring cardiac output and changing hemodynamic conditions during surgery accordingly is important to im...Background Assessment of cardiac function is crucial in pediatric patients undergoing cardiovascular surgery, monitoring cardiac output and changing hemodynamic conditions during surgery accordingly is important to improve post-surgical outcome. We aimed to measure cardiac index (CI) and maximal rate of the increase of left ventricular pressure dp/dt(max) with the pressure recording analytic method (PRAM, MostCare?) and compared it with transthoracic echocardiographic cardiac index estimation in infants with transposition of the great arteries (TGA) undergoing surgical correction. Methods We enrolled 74 infants with TGA consecutively into this study. CI and dp/dt(max) were measured with PRAM and echocardiography at 0, 4, 8, 12, 24 and 48 h postoperatively. Blood brain natriuretic peptide (BNP) and blood lactate (Lac) were measured at baseline and after operation. Results The median age at surgery was 13 days (range 1–25 days) with an average weight of 3.24 kg (range 2.31–4.17 kg). CI esti-mated by PRAM was 1.11 ± 0.12 L/min/m2 (range 0.69–1.36) and by Doppler echocardiography was 1.13 ± 0.13 L/min/m2 (range 0.76–1.40). dp/dt(max) estimated by PRAM was 1.31 ± 0.03 mmHg/s (range 1.23–1.43) and by Doppler echocardiography was 1.31 ± 0.04 L/min/m2 (range 1.25–1.47). CI (r = 0.817,P< 0.001) and dp/dt(max) (r = 0.794,P< 0.001) measured by two meth-ods were highly correlated with a linear relation. Blood BNP and lactate increased to the highest level at 8–12 h post-operatively. Conclusions In the early post-operative period, PRAM provides reliable estimates of cardiac index and dp/dt(max) value compared with echocardiographic measurements. PRAM through mostcare? is a reliable continuous monitoring method for peri-operative management in children with congenital heart disease.展开更多
文摘Objective This study attempted to seek a new Doppler-derived index for estimating ventricularsystolic function. Methods With custom - made software the aortic and pulmonic flow profiles were digitized andconverted to their 4V2 curves, their maximum value of the first derivative, max (dk/dt) were obtained separately in23 and 25patients with congenital heart disease (mean age 4.5 years). Aortic max(dk/dt) and pulmonic max(dk/dt)measured by Doppler were compared with left ventricular max(dp/dt) and right ventricular max(dp/dt) measuredby cardiac catheterization. Results Aortic max(dk/dt) correlated well with LV max(dp/dt) (r=0.817, P<0.001).An excellent correlation of pulmonic max(dk/dt) with RV max(dp/dt) was established (r=0.926, P<0.0001). Therewas a significant correlation between RVSP and RV max(dp/dt) (r= 0.839, P<0.0001). Conclusion Doppler - derived aortic max(dk/dt) and pulmonic max(dk/dt) could be reliable index of left ventricular contractility and rightventricular contractility respectively. When max(dp/dt) is used for assessing RV systolic function, the impact ofRVSP on that should be taken into consideration.
文摘Background Assessment of cardiac function is crucial in pediatric patients undergoing cardiovascular surgery, monitoring cardiac output and changing hemodynamic conditions during surgery accordingly is important to improve post-surgical outcome. We aimed to measure cardiac index (CI) and maximal rate of the increase of left ventricular pressure dp/dt(max) with the pressure recording analytic method (PRAM, MostCare?) and compared it with transthoracic echocardiographic cardiac index estimation in infants with transposition of the great arteries (TGA) undergoing surgical correction. Methods We enrolled 74 infants with TGA consecutively into this study. CI and dp/dt(max) were measured with PRAM and echocardiography at 0, 4, 8, 12, 24 and 48 h postoperatively. Blood brain natriuretic peptide (BNP) and blood lactate (Lac) were measured at baseline and after operation. Results The median age at surgery was 13 days (range 1–25 days) with an average weight of 3.24 kg (range 2.31–4.17 kg). CI esti-mated by PRAM was 1.11 ± 0.12 L/min/m2 (range 0.69–1.36) and by Doppler echocardiography was 1.13 ± 0.13 L/min/m2 (range 0.76–1.40). dp/dt(max) estimated by PRAM was 1.31 ± 0.03 mmHg/s (range 1.23–1.43) and by Doppler echocardiography was 1.31 ± 0.04 L/min/m2 (range 1.25–1.47). CI (r = 0.817,P< 0.001) and dp/dt(max) (r = 0.794,P< 0.001) measured by two meth-ods were highly correlated with a linear relation. Blood BNP and lactate increased to the highest level at 8–12 h post-operatively. Conclusions In the early post-operative period, PRAM provides reliable estimates of cardiac index and dp/dt(max) value compared with echocardiographic measurements. PRAM through mostcare? is a reliable continuous monitoring method for peri-operative management in children with congenital heart disease.
