PMID- 22748515 OWN - NLM STAT- MEDLINE DCOM- 20130122 LR - 20220316 IS - 1097-6833 (Electronic) IS - 0022-3476 (Print) IS - 0022-3476 (Linking) VI - 161 IP - 6 DP - 2012 Dec TI - Tissue Doppler imaging predicts adverse outcome in children with idiopathic pulmonary arterial hypertension. PG - 1126-31 LID - S0022-3476(12)00608-7 [pii] LID - 10.1016/j.jpeds.2012.05.050 [doi] AB - OBJECTIVE: To evaluate the clinical utility of tissue Doppler imaging (TDI) in assessment of disease severity and prognostic value in children with idiopathic pulmonary arterial hypertension (PAH). STUDY DESIGN: A prospective study was performed to evaluate TDI velocities (systolic myocardial velocity, early diastolic myocardial relaxation velocity [Em], late diastolic myocardial velocity associated with atrial contraction), brain natriuretic peptide, New York Heart Association (NYHA) functional class, and hemodynamics in 51 children (mean age; 11.6 years) with idiopathic PAH. Fifty-one healthy children with comparable demographics served as controls. RESULTS: Em, Em/late diastolic myocardial velocity associated with atrial contraction ratio, and systolic myocardial velocity at mitral annulus, septum, and tricuspid annulus in PAH were significantly reduced compared with controls. Tricuspid Em had significant inverse correlations with plasma brain natriuretic peptide levels (r = -0.60, P < .001), right ventricular end-diastolic pressure (r = -0.79, P < .001), and mean pulmonary arterial pressure (r = -0.67, P < .001). Statistically significant differences were observed in tricuspid Em between NYHA functional class II vs combined III and IV (mean and SD; 11.9 +/- 4.2 cm/s vs 8.2 +/- 3.6 cm/s, respectively, P = .002). Cumulative event-free survival rate was significantly lower when tricuspid Em was