Published in:
01-09-2004
Doppler Flow Parameters of Left Ventricular Filling in Infants: How Long Does It Take for the Maturation of the Diastolic Function in a Normal Left Ventricle to Occur?
Authors:
L. Schmitz, A. Xanthopoulos, H. Koch, P. E. Lange
Published in:
Pediatric Cardiology
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Issue 5/2004
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Abstract
Objective
To study the impact of the maturational process of diastolic left ventricular function on trans-mitral Doppler flow parameters.
Methods and Participants
In a survey we examined pulsed-wave Doppler signals and diastolic time intervals from 238 healthy neonates and infants. Using multiple linear regression analysis, we evaluated the impact of physiological determinants on parameter expression.
Results
Early-filling and atrial-filling peak velocities, early-filling acceleration and deceleration rates, and the atrial-filling time velocity integral reached a climax within 2 months after birth, while early-filling time velocity integral followed increasing throughout the study period. The isovolumic relaxation time was found to be significantly longer for neonates than for infants older than 2 months. The observed parameter movements could be attributed to changes of stroke volume and mitral valve area for early filling-time velocity integral (R2 = 0.93), and of heart rate, stroke volume, and mitral valve area for early filling peak velocity (R2 = 0.84), and atrial-filling time velocity integral (R2 = 0.65). Isovolumic relaxation time and atrial-filling peak velocity became heart rate dependent not before 3 months after birth.
Conclusions
The observed parameter changes are powerful indicators for the maturational process in diastolic function. This process is mainly completed by 3 months of age.