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Evaluation of short-term cardiac function by tissue Doppler imaging in pre and postoperative period of congenital heart disease

Korean Journal of Pediatrics 2007;50(5):476-483.
Published online May 15, 2007.
Evaluation of short-term cardiac function by tissue Doppler imaging in pre and postoperative period of congenital heart disease
Jun-Hwa Lee1, Yeo-Hyang Kim2, Myung-Chul Hyun3, Sang-Bum Lee3
1epartment of Pediatrics, School of Medicine, Sungkyunkwan University, Masan Samsung Hospital, Masan, Korea
2Department of Pediatrics, School of Medicine, Keimyung University, Daegu, Korea
3Department of Pediatrics, School of Medicine, Keimyung University, Daegu, Korea
조직 도플러 영상을 이용한 선천성 심장병 수술 전후의 단기 심기능 평가
이준화1, 김여향2, 현명철3, 이상범3
1마산삼성병원 소아과
2계명대학교 의과대학 소아과학교실
3경북대학교 의과대학 소아과학교실
Correspondence: 
Myung-Chul Hyun, Email: mchyun@mail.knu.ac.kr
Abstract
Purpose
: The objective of this study was to assess ventricular function by tissue Doppler imaging (TDI) in children with congenital heart disease (CHD) who have been undergoing open heart surgery (OHS) using cardiopulmonary bypass. We tried to compare the parameters of tissue Doppler imaging before and after OHS in patients with congenital heart disease.
Methods
: This study was conducted on 32 patients with CHD after OHS from January 2005 to December 2005 at Kyungpook National University hospital. Patients who underwent 2-D echocardiography before and after their OHS. All patients were divided into three groups, left ventricular volume overloading group (group 1), and right ventricular volume overloading group (group 2), and right ventricular pressure overloading group (group 3). The TDIs were examined before and 1 to 3 months after OHS. Peak early diastolic (E), and peak late diastolic (A) velocity of transmitral flow were measured by pulsed wave Doppler examination. Peak systolic (Sm), peak early diastolic (Em), and peak late diastolic (Am) velocity in apical 4-chamber and 2-chamber views were measured by TDI. The author calculated E/Em ratio.
Results
: The patients were 14 boys and 18 girls and the average age of patients was 2 years and 3 months. The congenital heart diseases which have to get OHS were ventricular septal defect (13 cases), atrial septal defect (7), atrioventricular septal defect (3), isolated pulmonary stenosis (2) and tetralogy of Fallot (7). There were significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view (P<0.05).
Conclusion
: This study showed significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view after OHS. These changes might be due to the effects of cardiopulmonary bypass in OHS and/or hemodynamic changes after correction of congenital heart disease. To clarify these changes, further study on more patients is needed.
Key Words: Congenital heart disease, Heart surgery, Doppler echocardiography, Ventricular function


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