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

Abstract

Increased ventricular end-diastolic pressure (VEDP) is a known risk factor for morbidity and mortality in patients with single right ventricle (RV) physiology. Previous studies have shown mixed results correlating echocardiographic measurements with catheter-derived VEDP in this population. Goal of this study was to evaluate if echocardiographic systolic/diastolic ratio (S/D) correlated with VEDP. Patients with single RV physiology who underwent simultaneous echocardiography 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. Twenty-seven studies were performed on patients with single RV physiology. Median age at time of catheterization was 11.4 months (range, 0-132 months). Mean VEDP was 9.9±4.5mm 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 discriminating between patients with high (>10mm 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. 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 discriminating between high and low VEDP in this complex patient population.