PDF(Pubmed)
Abstract：
BACKGROUND: Pediatric pulmonary hypertension (PH) is characterized by a mean pulmonary arterial pressure exceeding 20 mmHg. There is limited research on the suitability of adult-based methods for estimating PH in pediatric populations. Using established formulas for adults, this study aimed to evaluate the correlation between echocardiographic estimates of systolic, diastolic, and mean pulmonary arterial pressures, and mean right atrial pressures in children with congenital heart disease (CHD).
METHODS: A prospective study was conducted involving children with CHD undergoing cardiac catheterization without prior cardiac surgery. We used echocardiography to estimate pulmonary and right atrial pressures and compared these with invasively measured values. Four reliable regression equations were developed to estimate systolic, diastolic, and mean pulmonary arterial pressures, and mean right atrial pressures. Cutoff values were determined to predict the occurrence of PH. Linear regression, Bland-Altman analysis, and receiver operating characteristic curve analysis were performed to assess the accuracy of echocardiography and establish diagnostic thresholds for PH.
RESULTS: The study involved 55 children (23 with normal pulmonary arterial pressure and 32 with PH) with acyanotic CHD aged 1 to 192 months. Four equations were developed to detect high pulmonary arterial pressures, with cutoff values of 32.9 for systolic pulmonary arterial pressure, 14.95 for diastolic pulmonary arterial pressure, and 20.7 for mean pulmonary arterial pressure. The results showed high sensitivity and moderate specificity but a tendency to underestimate systolic and mean pulmonary arterial pressures at higher pressures.
CONCLUSIONS: The study provides valuable insights into the use of adult-based echocardiographic formulas for estimating PH in pediatric patients with acyanotic CHD.
METHODS: A prospective study was conducted involving children with CHD undergoing cardiac catheterization without prior cardiac surgery. We used echocardiography to estimate pulmonary and right atrial pressures and compared these with invasively measured values. Four reliable regression equations were developed to estimate systolic, diastolic, and mean pulmonary arterial pressures, and mean right atrial pressures. Cutoff values were determined to predict the occurrence of PH. Linear regression, Bland-Altman analysis, and receiver operating characteristic curve analysis were performed to assess the accuracy of echocardiography and establish diagnostic thresholds for PH.
RESULTS: The study involved 55 children (23 with normal pulmonary arterial pressure and 32 with PH) with acyanotic CHD aged 1 to 192 months. Four equations were developed to detect high pulmonary arterial pressures, with cutoff values of 32.9 for systolic pulmonary arterial pressure, 14.95 for diastolic pulmonary arterial pressure, and 20.7 for mean pulmonary arterial pressure. The results showed high sensitivity and moderate specificity but a tendency to underestimate systolic and mean pulmonary arterial pressures at higher pressures.
CONCLUSIONS: The study provides valuable insights into the use of adult-based echocardiographic formulas for estimating PH in pediatric patients with acyanotic CHD.
摘要：
背景：小儿肺动脉高压（PH）的特征是平均肺动脉压超过20mmHg。关于基于成人的方法在儿科人群中估计PH的适用性的研究有限。使用既定的成人配方，这项研究旨在评估超声心动图对收缩压的估计之间的相关性，舒张压,和平均肺动脉压，先天性心脏病（CHD）儿童的平均右心房压。
方法：进行了一项前瞻性研究，涉及冠心病患儿在没有进行心脏手术的情况下接受心导管检查。我们使用超声心动图来估计肺和右心房压力，并将其与侵入性测量值进行比较。开发了四个可靠的回归方程来估计收缩压，舒张压,和平均肺动脉压，和平均右心房压力。确定截止值以预测PH的发生。线性回归，Bland-Altman分析,和受试者工作特征曲线分析用于评估超声心动图的准确性并建立PH的诊断阈值。
结果：该研究涉及55名1至192个月的非紫花苜蓿CHD儿童（23名肺动脉压正常，32名PH正常）。开发了四个方程来检测高肺动脉压，收缩期肺动脉压的临界值为32.9，14.95肺动脉舒张压，平均肺动脉压20.7。结果显示出高灵敏度和中等特异性，但在较高压力下倾向于低估收缩压和平均肺动脉压。
结论：该研究为使用成人超声心动图公式评估儿童非紫花苜蓿性CHD患者的PH提供了有价值的见解。
方法：进行了一项前瞻性研究，涉及冠心病患儿在没有进行心脏手术的情况下接受心导管检查。我们使用超声心动图来估计肺和右心房压力，并将其与侵入性测量值进行比较。开发了四个可靠的回归方程来估计收缩压，舒张压,和平均肺动脉压，和平均右心房压力。确定截止值以预测PH的发生。线性回归，Bland-Altman分析,和受试者工作特征曲线分析用于评估超声心动图的准确性并建立PH的诊断阈值。
结果：该研究涉及55名1至192个月的非紫花苜蓿CHD儿童（23名肺动脉压正常，32名PH正常）。开发了四个方程来检测高肺动脉压，收缩期肺动脉压的临界值为32.9，14.95肺动脉舒张压，平均肺动脉压20.7。结果显示出高灵敏度和中等特异性，但在较高压力下倾向于低估收缩压和平均肺动脉压。
结论：该研究为使用成人超声心动图公式评估儿童非紫花苜蓿性CHD患者的PH提供了有价值的见解。
