Open Access

ARTICLE

Systolic/diastolic ratio correlates with end diastolic pressures in pediatric patients with single right ventricles

Clifford L. Cua¹, Melissa Moore‐Clingenpeel¹, Nazia Husain², Ralf Holzer³, John P. Cheatham¹, Janaki Gokhale⁴

1 Heart Center, Nationwide Children’s Hospital, Columbus, Ohio
2 Pediatric Cardiology, Lurie Children’s Hospital, Chicago, Illinois
3 New York‐Presbyterian/Weill Cornell Medical Center, New York City, New York
4 Pediatric Cardiology, Lucille Packard Children’s Hospital, Palo Alto, California

* Corresponding Author: Clifford L. Cua, Heart Center, Nationwide Children’s Hospital, Columbus, OH 43205. Email:

Congenital Heart Disease 2019, 14(4), 609-613. https://doi.org/10.1111/chd.12755

Abstract

Background: Increased ventricular end‐diastolic pressure (VEDP) is a known risk fac‐ tor for morbidity and mortality in patients with single right ventricle (RV) physiology. Previous studies have shown mixed results correlating echocardiographic measure‐ ments with catheter‐derived VEDP in this population. Goal of this study was to eval‐ uate if echocardiographic systolic/diastolic ratio (S/D) correlated with VEDP.
Methods: Patients with single RV physiology who underwent simultaneous echocar‐ diography and catheterization were evaluated. Systolic and diastolic durations were measured using tricuspid inflow durations from Doppler analysis to calculate the S/D ratio. VEDP was obtained from the catheterization report.
Results: Twenty‐seven studies were performed on patients with single RV physiol‐ ogy. Median age at time of catheterization was 11.4 months (range, 0‐132 months). Mean VEDP was 9.9 ± 4.5 mm Hg. S/D ratio was 1.8 ± 0.5. S/D ratio significantly correlated with VEDP (r = 0.63, P < .01). Optimum value of S/D ratio for discriminat‐ ing between patients with high (>10 mm Hg) vs low EDP was found to be 1.9. High S/D ratio had an area under the curve of 0.82 (0.65, 1.0), with 75% sensitivity and 89% specificity for predicting elevated VEDP.
Conclusion: In patients with single RV physiology, S/D significantly correlated with VEDP. S/D ratio is a simple technique that may be useful in both estimating and dis‐ criminating between high and low VEDP in this complex patient population.

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