摘要
Objectives: To compare tissue Doppler (TD) velocities between patients with di lated cardiomyopathy (DCM) and normal controls and to determine whether TD veloc ities, Tei index, right ventricular fractional area change, and left ventricular ejection fraction (LVEF) predict adverse clinical outcomes in children with DCM . Methods: Prospective evaluation of children with DCM. Results: 54 children wit h DCM and 54 age and sex matched control group participants were studied. Mitral inflow velocities were similar for both groups except for decreased mitral dece leration time in patients with DCM. Systolic and diastolic TD velocities at the mitral annulus (septal and lateral sides) and tricuspid annulus were significant ly reduced in children with DCM compared with controls (p< 0.001 for each). By m ultivariate analysis, after adjustment for Tei index and right ventricular fract ional area change, decreased LVEF and tricuspid velocity during early diastole ( Ea) were predictors of the primary end point (PEP), a composite end point consis ting of need for hospitalisation or the outcome transplantation or death. Tricus pid Ea velocity < 8.5 cm/s had 87%specificity and 60%sensitivity for reaching the PEP. LVEF < 30%had 68%specificity and 74%sensitivity for the PEP. Combine d LVEF < 30%and tricuspid Ea < 11.5 cm/s had 100%specificity and 44%sensitivi ty for the PEP. Conclusions: Children with DCM have significantly lower TD veloc ities than normal controls. In such cases, lower LVEF (< 30%) is more sensitive but less specific than lower tricuspid Ea velocities (< 8.5 cm/s) in predicting which patients are at risk of hospitalisation, transplantation, or death.
Objectives: To compare tissue Doppler (TD) velocities between patients with di lated cardiomyopathy (DCM) and normal controls and to determine whether TD veloc ities, Tei index, right ventricular fractional area change, and left ventricular ejection fraction (LVEF) predict adverse clinical outcomes in children with DCM . Methods: Prospective evaluation of children with DCM. Results: 54 children wit h DCM and 54 age and sex matched control group participants were studied. Mitral inflow velocities were similar for both groups except for decreased mitral dece leration time in patients with DCM. Systolic and diastolic TD velocities at the mitral annulus (septal and lateral sides) and tricuspid annulus were significant ly reduced in children with DCM compared with controls (p< 0.001 for each). By m ultivariate analysis, after adjustment for Tei index and right ventricular fract ional area change, decreased LVEF and tricuspid velocity during early diastole ( Ea) were predictors of the primary end point (PEP), a composite end point consis ting of need for hospitalisation or the outcome transplantation or death. Tricus pid Ea velocity < 8.5 cm/s had 87%specificity and 60%sensitivity for reaching the PEP. LVEF < 30%had 68%specificity and 74%sensitivity for the PEP. Combine d LVEF < 30%and tricuspid Ea < 11.5 cm/s had 100%specificity and 44%sensitivi ty for the PEP. Conclusions: Children with DCM have significantly lower TD veloc ities than normal controls. In such cases, lower LVEF (< 30%) is more sensitive but less specific than lower tricuspid Ea velocities (< 8.5 cm/s) in predicting which patients are at risk of hospitalisation, transplantation, or death.
