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Left atrial stiffness and strain are novel indices of left ventricular diastolic function in children: validation followed by application in multisystem inflammatory syndrome in children due to COVID-19.
Zuckerberg, Jeremy C; Matsubara, Daisuke; Kauffman, Hunter L; Chang, Joyce C; Calderon-Anyosa, Renzo; Patel, Chandni; Hogarty, Alexa N; Falkensammer, Christine B; Mercer-Rosa, Laura M; Quartermain, Michael D; Wang, Yan; Banerjee, Anirban.
Afiliación
  • Zuckerberg JC; Division of Cardiology, Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
  • Matsubara D; Division of Cardiology, Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
  • Kauffman HL; Division of Cardiology, Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
  • Chang JC; Division of Rheumatology, Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
  • Calderon-Anyosa R; Division of Cardiology, Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
  • Patel C; Division of Cardiology, Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
  • Hogarty AN; Division of Cardiology, Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
  • Falkensammer CB; Division of Cardiology, Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
  • Mercer-Rosa LM; Division of Cardiology, Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
  • Quartermain MD; Division of Cardiology, Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
  • Wang Y; Division of Cardiology, Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
  • Banerjee A; Division of Cardiology, Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Eur Heart J Cardiovasc Imaging ; 24(9): 1241-1251, 2023 08 23.
Article en En | MEDLINE | ID: mdl-37159912
AIMS: We hypothesized left atrial (LA) stiffness may serve as a surrogate marker in children to differentiate elevated pulmonary capillary wedge pressure (PCWP) from normal and help detect diastolic dysfunction in myocardial injury due to multisystem inflammatory syndrome in children (MIS-C). METHODS AND RESULTS: We validated LA stiffness in 76 patients (median age 10.5 years), 33 had normal PCWP (<12 mmHg) and 43 had elevated PCWP (≥12 mmHg). LA stiffness was applied to 42 MIS-C patients [28 with myocardial injury (+) and 14 without myocardial injury (-)], defined by serum biomarkers. The validation group consisted of a group with and without cardiomyopathies, whose PCWP values ranged from normal to severely elevated. Peak LA strain was measured by speckle-tracking and E/e' from apical four chamber views. Noninvasive LA stiffness was calculated as: LAStiffness=E/e'LAPeakStrain (%-1). Patients with elevated PCWP showed significantly elevated LA stiffness [median 0.71%-1 vs. 0.17%-1, P < 0.001]. Elevated PCWP group showed significantly decreased LA strain (median: 15.0% vs. 38.2%, P < 0.001). Receiver operator characteristic (ROC) curve for LA stiffness yielded an area under the curve (AUC) of 0.88 and cutoff value of 0.27%-1. In MIS-C group, ROC curve yielded an AUC of 0.79 and cutoff value of 0.29%-1 for identifying myocardial injury. CONCLUSION: In children with elevated PCWP, LA stiffness was significantly increased. When applied to children with MIS-C, LA stiffness classified myocardial injury accurately. LA stiffness and strain may serve as noninvasive markers of diastolic function in the pediatric population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / COVID-19 Tipo de estudio: Prognostic_studies Límite: Child / Humans Idioma: En Revista: Eur Heart J Cardiovasc Imaging Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / COVID-19 Tipo de estudio: Prognostic_studies Límite: Child / Humans Idioma: En Revista: Eur Heart J Cardiovasc Imaging Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido