Another useful index of ventricular function in patients with single ventricle

Abstract

In the thoughtful article, “Quantitative Assessment of Ventricular Function in Children With Single Ventricles Using the Doppler Myocardial Performance Index,” by Williams et al, 1 Williams R.V. Ritter S. Tani L.Y. Pagotto L.T. Minich L.L. Quantitative assessment of ventricular function in children with single ventricles using the Doppler myocardial performance index. Am J Cardiol. 2000; 86: 1106-1110 Abstract Full Text Full Text PDF PubMed Scopus (78) Google Scholar the authors incorrectly state that “Evaluation of preejection phase indexes, such as dP/dt, depends on the presence of systemic atrioventricular valve regurgitation.” In fact, however, the mean dP/dt during isovolumetric contraction (mean dP/dtic) is a preejection phase index that does not require the presence of atrioventricular valve regurgitation. Indeed, it can be generated from M-mode echocardiographic tracings of any patient’s aortic and systemic atrioventricular valves. Mean dP/dtic is independent of geometric assumptions and has been found to approximate and closely correlate with invasive measurements of peak dP/dt, even among patients with complex congenital heart disease. 2 Rhodes J. Udelson J.E. Marx G.R. Schmidt C.H. Konstam M.A. Hijazi Z.M. Bova S.A. Fulton D.R. A new noninvasive method for the estimation of peak dP/dt. Circulation. 1993; 88: 2693-2699 Crossref PubMed Scopus (52) Google Scholar The clinical utility of mean dP/dtic has been demonstrated in a variety of settings, and it is particularly useful in the assessment of ventricular function in patients with single ventricle. 3 Rhodes J. Marx G.R. Tardiff J.C. Romero B.A. Robinson A.R. Pandian N. Fulton D.R. Transesophageal echocardiographic evaluation of ventricular dP/dt before and after open heart surgery. Echocardiography. 1997; 14: 15-22 Crossref PubMed Scopus (10) Google Scholar , 4 Rhodes J. Fulton D.R. Levine J.C. Marx G.R. Comparison between the mean dP/dt during isovolumetric contraction and other echocardiographic indices of ventricular function. Echocardiography. 1997; 14: 215-222 Crossref PubMed Scopus (7) Google Scholar A comparison of data derived from measurements of mean dP/dtic with those obtained using the Doppler myocardial performance index may be informative.