Doppler tissue imaging in children following cardiac transplantation: A comparison to catheter derived hemodynamics.

Previous studies have demonstrated a correlation between E:E_a and ventricular filling pressure in adults after heart transplantation. We sought to determine if E:E_a correlates with filling pressure after heart transplantation in children. A prospective analysis of children who have undergone heart transplantation was performed. Inflow and myocardial velocities were recorded and compared to catheter-derived filling pressures and rejection status. We performed 61 studies in 49 subjects. No correlation was found between septal E:E_a and PCWP (r = 0.14, p = 0.28); or between lateral tricuspid E:E_a and mean RAp (r = 0.04, p = 0.79). However, the mean PCWP was higher among subjects with elevated septal E:E_a (>12) compared to normal E:E_a (12.3 ± 2.8 mmHg vs. 10.1 ± 2.9 mmHg, p = 0.02). Similarly, mean RAp was higher among subjects with an elevated lateral tricuspid E:E_a (>10) compared to normal lateral tricuspid E:E_a (7.7 ± 2.1 mmHg vs. 6.0 ± 2.4 mmHg, p = 0.04). Elevated septal E:E_a was also associated with high-grade cellular rejection (OR = 17.3 [95% CI 1.4-221], p = 0.028). In children following heart transplant, E:E_a does not correlate well with the range of filling pressures seen after pediatric heart transplantation. However, a septal E:E_a > 12 is associated with elevated PCWP and high grade cellular rejection and a lateral tricuspid E:E_a > 10 is associated with elevated mean RAp. [ABSTRACT FROM AUTHOR]