PMID- 29896859
OWN - NLM
STAT- MEDLINE
DCOM- 20181108
LR  - 20210109
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 41
IP  - 9
DP  - 2018 Sep
TI  - Right ventricular base/apex ratio in the assessment of pediatric pulmonary 
      arterial hypertension: Results from the European Pediatric Pulmonary Vascular 
      Disease Network.
PG  - 1144-1149
LID - 10.1002/clc.22994 [doi]
AB  - BACKGROUND: Echocardiographic determination of RV end-systolic base/apex (RVES 
      b/a) ratio was proposed to be of clinical value for assessment of pulmonary 
      arterial hypertension (PAH) in adults. HYPOTHESIS: We hypothesized that the RVES 
      b/a ratio will be affected in children with PAH and aimed to correlate RVES b/a 
      ratio with conventionally used echocardiographic and hemodynamic variables, and 
      with New York Heart Association (NYHA) functional class. METHODS: First we 
      determined normal pediatric values for RVES b/a ratio in 157 healthy children (68 
      males; age range, 0.5-17.7 years). We then conducted an echocardiographic study 
      in 51 children with PAH (29 males; age range, 0.3-17.8 years). RESULTS: RVES b/a 
      ratio was lower compared with age- and sex-matched healthy controls (P < 0.001). 
      In children with PAH, RVES b/a ratio decreased with worsening NYHA class. RVES 
      b/a ratio inversely correlated with RV/LV end-systolic diameter ratio (rho = 
      -0.450, P = 0.001) but did not correlate with RV systolic function parameters 
      (eg, tricuspid annular plane systolic excursion) and correlated with cardiac 
      catheterization-determined pulmonary vascular resistance index (rho = -0.571, P < 
      0.001). ROC analysis unraveled excellent performance of RVES b/a ratio to detect 
      PAH in children (AUC: 0.95, 95% CI: 0.89-1.00, P < 0.001). CONCLUSIONS: The RVES 
      b/a ratio decreased in children with PAH compared with age- and sex-matched 
      healthy subjects. The RVES b/a ratio inversely correlated with both 
      echocardiographic and hemodynamic indicators of increased RV pressure afterload 
      and with NYHA class, suggesting that RVES b/a ratio reflects disease severity in 
      PAH children.
CI  - (c) 2018 Wiley Periodicals, Inc.
FAU - Koestenberger, Martin
AU  - Koestenberger M
AUID- ORCID: 0000-0003-1766-7859
AD  - Division of Pediatric Cardiology, Department of Pediatrics, Medical University 
      Graz, Graz, Austria.
FAU - Avian, Alexander
AU  - Avian A
AD  - Institute for Medical Informatics, Statistics and Documentation, Medical 
      University Graz, Graz, Austria.
FAU - Gamillscheg, Andreas
AU  - Gamillscheg A
AD  - Division of Pediatric Cardiology, Department of Pediatrics, Medical University 
      Graz, Graz, Austria.
FAU - Sallmon, Hannes
AU  - Sallmon H
AD  - Department of Pediatric Cardiology, Charite-Universitatsmedizin Berlin, Berlin, 
      Germany.
FAU - Grangl, Gernot
AU  - Grangl G
AD  - Division of Pediatric Cardiology, Department of Pediatrics, Medical University 
      Graz, Graz, Austria.
FAU - Burmas, Ante
AU  - Burmas A
AD  - Division of Pediatric Cardiology, Department of Pediatrics, Medical University 
      Graz, Graz, Austria.
FAU - Schweintzger, Sabrina
AU  - Schweintzger S
AD  - Division of Pediatric Cardiology, Department of Pediatrics, Medical University 
      Graz, Graz, Austria.
FAU - Kurath-Koller, Stefan
AU  - Kurath-Koller S
AD  - Division of Pediatric Cardiology, Department of Pediatrics, Medical University 
      Graz, Graz, Austria.
FAU - Cvirn, Gerhard
AU  - Cvirn G
AD  - Centre of Physiological Medicine, Medical University Graz, Graz, Austria.
FAU - Hansmann, Georg
AU  - Hansmann G
AD  - Department of Pediatric Cardiology and Critical Care, Hannover Medical School, 
      Hannover, Germany.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20180818
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
SB  - IM
CIN - Clin Cardiol. 2018 Sep;41(9):1150-1151. PMID: 30069895
CIN - Clin Cardiol. 2018 Sep;41(9):1152-1153. PMID: 30069929
MH  - Adolescent
MH  - Cardiac Catheterization
MH  - Child
MH  - Child, Preschool
MH  - Echocardiography/*methods
MH  - Europe
MH  - Female
MH  - Heart Ventricles/*diagnostic imaging/physiopathology
MH  - Humans
MH  - Hypertension, Pulmonary/*diagnosis/physiopathology
MH  - Infant
MH  - Male
MH  - Pulmonary Artery/*diagnostic imaging/physiopathology
MH  - Pulmonary Circulation/*physiology
MH  - Societies, Medical/statistics & numerical data
MH  - Stroke Volume/*physiology
MH  - Systole
MH  - Ventricular Function, Right/*physiology
PMC - PMC6489923
OTO - NOTNLM
OT  - Echocardiography
OT  - End-Systolic Base/Apex Ratio
OT  - Pediatric
OT  - Pulmonary Arterial Hypertension
OT  - Right Ventricle
COIS- GH currently receives grant support from the German Research Foundation (DFG; HA 
      4348/6-1, KFO311). The authors declare no other potential conflicts of interest.
EDAT- 2018/06/14 06:00
MHDA- 2018/11/09 06:00
PMCR- 2018/08/18
CRDT- 2018/06/14 06:00
PHST- 2018/04/19 00:00 [received]
PHST- 2018/05/18 00:00 [revised]
PHST- 2018/06/10 00:00 [accepted]
PHST- 2018/06/14 06:00 [pubmed]
PHST- 2018/11/09 06:00 [medline]
PHST- 2018/06/14 06:00 [entrez]
PHST- 2018/08/18 00:00 [pmc-release]
AID - CLC22994 [pii]
AID - 10.1002/clc.22994 [doi]
PST - ppublish
SO  - Clin Cardiol. 2018 Sep;41(9):1144-1149. doi: 10.1002/clc.22994. Epub 2018 Aug 18.