1158 Systolic-Diastolic Function in Congestive Heart Failure Secondary to Congenital Heart Malformations Evaluated by Classical and Tissue Doppler Echocardiography

Background and Aims Tissue Doppler velocities are relatively independent of ventricular geometry, particularly right ventricular geometry that is predominantly affected in the case of congenital heart disease (CHD). Aims The evaluation of systolic and diastolic function in pediatric patients with congestive heart failure (CHF) secondary to CHD using classical echocardiographic parameters and pulsed tissue Doppler parameters. Methods The study included 27 children diagnosed with CHF secondary to congenital heart malformations. The parameters of systolic and diastolic function were measured by 2D echocardiography, 2D guided M mode, color and pulsed Doppler, as well as by pulsed tissue Doppler at the level of the mitral and tricuspid annulus. Results A relaxation alteration pattern or a pseudonormal pattern of E diastolic velocity compared to the A wave was found (E=A; E>A) in the group of subjects with heart failure. E wave deceleration time (EDT) had significantly increased values in the case of patients with CHF, being correlated with diastolic dysfunction. Left ventricular flow propagation velocity Vp was decreased in patients with heart failure. Associations between the severity of systolic dysfunction and the diastolic dysfunction evaluated by 2D echocardiographic parameters, M mode and Doppler and measured by pulsed tissue Doppler velocities at the mitral and tricuspid annulus were found in pediatric patients diagnosed with congestive heart failure (p<0.05). Conclusions In children with heart failure, some conventional parameters of the diastolic function were maintained within normal or pseudonormal values, diastolic dysfunction being confirmed in these cases by tissue Doppler measurements.