Clinical evaluation of right ventricular function in children with ventricular septal defect complicated by pulmonary artery hypertension

Objective Discuss the value of TDI, STI and serum BNP in evaluating right ventricular function in children with VSD complicated by pulmonary artery hypertension (PAH). Methods A total of 68 children with VSD and 24 age-matched healthy children were involved in this research. The patients were divided into mild(n=23), moderate(n=21) and severe(n=24) groups according to pulmonary artery pressure. Two-dimensional standard apical four-chamber image of consecutive three cardiac cycles were preserved by GE Vivid 7 to obtain GLS and GLSR. PW-TDI of tricuspid annulus motion curve was recorded to measure Sa,IVA and Tei. Tricuspid annulus plane systolic excursion(TAPSE) was measured through M-mode echocardiography.BNP was detected by ELIASA. Results (1) Tricuspid annulus IVA and TAPSE decreased with the increase of PAH, but Tei index increased with the PAH(P 0.01).The three parameters had significant difference except those between control group and mild group. Sa had significant difference except that between control group and mild group, moderate and severe group. (2) GLS and GLSR decreased with the increase of PAH;GLS had statistically significant difference between the groups. GLSR had significant difference except that between control group and mild group, moderate and severe group. (3)Serum BNP increased in accordance with PAH and had significant difference between the groups. (4)BNP and Tei index correlated better with NYHA. Conclusion TDI and STI parameters can reflect the right ventricular function of children with VSD complicated by pulmonary hypertension. BNP and Tei index correlate with NYHA better. BNP and GLS can reflect mild impair of the right ventricle.