Abstract 18823: Longitudinal Measures of Deformation Are Associated With a Novel Composite Measure of Contractility Derived From Pressure-Volume Loop Analysis in Children
Introduction: The relationship between echocardiographic measures of left ventricular (LV) systolic function and reference-standard measures have not been assessed in children. The objective of this study was to assess the validity of echocardiographic indices of LV systolic function via direct comparison to a novel composite measure of contractility derived from pressure-volume loop (PVL) analysis.
Methods: Children with normal loading conditions undergoing routine left heart catheterization were prospectively enrolled. PVLs were obtained via conductance catheters. A novel invasive composite contractility index (ICCI) was developed using data reduction strategies to combine four measures of contractility derived from PVL analysis. Similar strategies were used to develop composites of preload and afterload. Echocardiograms were performed immediately after PVL analysis under the same anesthetic conditions. Conventional and speckle-tracking echocardiographic measures of systolic function were measured.
Results: Of 24 patients, 18 patients were heart transplant recipients, 6 patients had a small patent ductus arteriosus or small coronary fistula. Mean age was 9.1 ± 5.6 years. Upon multivariable regression, longitudinal strain was associated with ICCI (β = -0.54, p = 0.02) while controlling for indices of preload, afterload, heart rate, and LV mass under baseline conditions. Ejection fraction and shortening fraction were associated with LV mass and load indices, but not contractility. Comprehensive results can be found in the table.
Conclusion: We developed a novel measure of contractility, the ICCI, in children. Speckle-tracking derived longitudinal strain is associated ICCI in children with normal loading conditions. Longitudinal strain appears to be an accurate surrogate for LV contractility under baseline conditions in children.
Author Disclosures: S.M. Chowdhury: None. R. Butts: None. C. Taylor: None. V. Bandisode: None. K. Chessa: None. A. Hlavacek: None. A. Nutting: None. G. Shirali: None. G.H. Baker: None.
- © 2016 by American Heart Association, Inc.