Relation of Mean Right Atrial Pressure to Doppler Parameters of Right Atrial and Hepatic Venous Flow in Pediatric Patients with Congenital Heart Disease

  • Dr Hamid Amoozgar, Shiraz University of Medical Sciences, Iran
  • Dr khobiar Zare, Shiraz University of Medical Sciences, Iran
  • Proff Mohammad Borzoee, Shiraz University of Medical Sciences, Iran
  • Dr Gholamhossein Ajami, Shiraz University of Medical Sciences, Iran
  • Dr Saiid Abtahi, Shiraz University of Medical Sciences, Iran

    • Background: A paucity of data exists regarding the relation of mean right atrial pressure (RAP) to Doppler parameters of right atrial and ventricular filling in pediatric patients with congenital heart disease.

    Methods: fifty patients (30 male and 20 female) with mean age of 4.96 +- 4.05who were admitted in the pediatric cardiology ward of Shiraz medical university affiliated hospital, Nemazee Hospital, Shiraz, Iran were included in this study. Data gathered from hepatic venous flow, tricuspid diastolic flow and Pulse tissue Doppler of lateral tricuspid annulus of each patient were then compared with right atrial pressure obtained by cardiac catheterization.

    Results: If change of peak S wave velocity of hepatic vein in respiration was more than 63.1%, sensitivity and specificity of a RA pressure more than 8 mmHg were 90% and 51.3% respectively with likelihood ratio (LR) equal to 1.85; A peak S wave velocity of less than 70 mm/Sec also showed a RA pressure more than 8 mmHg with sensitivity and specificity of 70 and 82.1 respectively (LR=3.9).A peak D wave velocity of hepatic vein more than 63 mm/sec was indicator of RA pressure more than 8 mmHg with sensitivity and specificity of 60% and 92.3% respectively (LR=7.8).

    Conclusion: This study showed that hepatic venous flow can be valuable for estimation of mean RA pressure in pediatric patients with congenital heart disease.