Table 4.
Echocardiographic views to obtain functional parameters in pediatric PH.
| View | Functional parameters | |
|---|---|---|
| Anatomy | Parasternal short axis | End-systolic RV/LV ratio325 |
| Doppler | Parasternal short axis | Pulmonary acceleration time/ejection time |
| Pulmonary regurgitation early and late diastolic velocity | ||
| Apical four-chamber | Tricuspid regurgitation severity (none, mild, moderate, severe) | |
| Tricuspid regurgitation peak velocity | ||
| Myocardial performance index (tricuspid tissue Doppler)327 | ||
| Systolic/diastolic (S/D) duration ratio from TR Doppler272 | ||
| Tissue Doppler systolic and diastolic velocities (tricuspid, septal, mitral) | ||
| Right atrium | Apical four-chamber | Right atrial area (RA) |
| Right ventricle | Apical four-chamber | Qualitative RV function (good, mildly/moderately/severely depressed) |
| RV end-diastolic and end-systolic dimensions indexed for BSA (2D) | ||
| Fractional area of change (FAC) % | ||
| Tricuspid annular planar systolic excursion (TAPSE) with z-score (M-mode when available, 2D) | ||
| RV strain (global and segmental)43,326,328 | ||
| 3D RV volumes and function268,326 | ||
| Left ventricle | Apical two- and four-chamber | LV ejection fraction (bi-plane Simpson or 5/6 area-length method) |
| LV eccentricity index317 | ||
| LV strain (global)329 | ||
| 3D LV volumes and function324 | ||
| Other | Presence and severity of pericardial effusion (none, small, moderate, large)231 |
RV, right ventricle; LV, left ventricle; TR, tricuspid regurgitant jet; BSA, body surface area.