Role of echocardiography in primary diagnosis of dilative cardiomyopathy in children - clinical and hemodynamic relations

Abstract

The objective of the work was the assessment of changes in echocardiographic and their primary diagnosis of dilated cardiomyopathy in children. The retrospective study included 11 patients consecutively admitted during 2006-2009 in the service of pediatric cardiology and C in ICSOSM diagnosed with dilated cardiomyopathy (DCM). The study also included children of both sexes (3girls, 8boys), age within 3 months - 16 years (average 6. 4 years). Echocardiographic examination (EcoCG) was performed in M mode, 2D and Doppler (AcusonX300 System). EcoCg examination included determining the following relevant hemodynamic parameters in diagnosis of DCM (P.Elliott, 2000; F.E. Wilklow , 2008): size of left and right heart cavities (LVDD, LVSD, LAD, RVD), left ventricular contraction function (EF, SF). MPI (Tei index, C. Tei, 1997) was calculated simultaneously, reference values are dependent on age. EcoCg measurements obtained were compared with normal values for age in relation to BMI (R. Kampmann, 2000). It has been found correlations between parameters EF, SF, MP1 and the severity of CHF (NYHA / Ross). The clinical and paraclinical examination of patients determined: male predominance (73%). 63.3% of patients had severe HF (3-4 NYHA / Ross). Echocardiographic index values: Ao (16 ± 2. 03, p 0. 03), LAD (32 ± 1. 9, p 0. 0002), LVDD (46 ± 4, p <0. 001), LVSD (40 ± 3. 3, p <0. 0001), RVD (14 ± 2. 1, p 0. 2) are significantly increased compared with normal values reported to BMI. EF (38 ± 3. 6, p <0. 0001), SF (19 ± 2. 1, p <0. 0001) are reduced. Myocardial performance index values (0. 76 ± 0. 06, p <0. 0001) are enlarged. 36% of patients on the background of a normal EF (53±2.35%), show the increased Tei index (0. 57±0.0095). Initial clinical presentation in children with DCM is mostly serious HF (63.3% with FC NYHA / Ross III-IV). EcoCg parameters reported to the BMI are more relevant in diagnosis of dilated cardiomyophathy. Mentioning, that Tei index allow more objective appreciation of function of heart muscle contraction, even in cases with EF and SF preserved, which allows early initiation of appropriate treatment.