Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Variation of parameters according to cardiac cycle length, evaluated by TDI in children

소아에서 심장 주기 시간 변화에 따른 조직 도플러 지표들의 변화양상

  • Lee, Chang-Hyun (Department of Pediatrics, Gangneung Asan Hospital, College of Medicine, Ulsan University) ;
  • Kim, Jae-Kwang (Department of Pediatrics, Gangneung Asan Hospital, College of Medicine, Ulsan University) ;
  • Jin, Hyun-Seung (Department of Pediatrics, Gangneung Asan Hospital, College of Medicine, Ulsan University) ;
  • Park, Kie-Young (Department of Pediatrics, Gangneung Asan Hospital, College of Medicine, Ulsan University) ;
  • Kim, Bong-Seong (Department of Pediatrics, Gangneung Asan Hospital, College of Medicine, Ulsan University) ;
  • Han, Myung-Ki (Department of Pediatrics, Gangneung Asan Hospital, College of Medicine, Ulsan University)
  • 이창현 (울산대학교 의과대학 강릉아산병원 소아청소년과) ;
  • 김재광 (울산대학교 의과대학 강릉아산병원 소아청소년과) ;
  • 진형승 (울산대학교 의과대학 강릉아산병원 소아청소년과) ;
  • 박기영 (울산대학교 의과대학 강릉아산병원 소아청소년과) ;
  • 김봉선 (울산대학교 의과대학 강릉아산병원 소아청소년과) ;
  • 한명기 (울산대학교 의과대학 강릉아산병원 소아청소년과)
  • Received : 2008.08.25
  • Accepted : 2008.11.06
  • Published : 2009.03.15
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Abstract

Purpose : This study aimed to determine the variation in parameters according to cardiac cycle length (CL; time interval between the QRS peaks on ECG) in children by using the conventional pulsed Doppler and tissue Doppler imaging echocardiography. Methods : Eighteen children with an anatomically normal heart were enrolled for the study. All children were examined by conventional and pulsed Doppler echocardiography at Gangneung Asan hospital between July 2006 and June 2007. We measured the CLs, mitral inflow velocities (E,A) and tissue Doppler imaging (TDI) parameters (s', e', a') from apical 4-chamber view. The TDI parameters were measured at the lateral (Lat) and septal (Sep) part of the mitral valve. All parameters were measured at 6 to 18 consecutive beats from each child. We then evaluated the linear correlation between CL and each parameter. Results : The mean age was $3.6{\pm}0.5$ years (M:F=8:10). There were significantly negative linear correlations between CL and A, Lat s', Lat a', Sep s', Sep e', Sep a' (P<0.01). There were significantly positive linear correlations between CL and E/A, Lat e'/a', Sep e'/a' (P<0.01). However, the E and Lat e' were not correlated with CL (P=0.229 and 0.221, respectively). Conclusion : This study showed that the values of the left ventricular functional parameters were changed according to CL. From our results, it is imperative to carefully examine beat-to-beat variations in children.

목 적 : 이 연구의 목적은 소아에서 고식적 심초음파와 조직 도플러 영상을 이용하여 측정한 지표들의 심장 주기 시간에 따른 변화를 알아보기 위함이다. 방 법 : 2006년 7월부터 2007년 6월까지 강릉아산병원에서 심장초음파를 시행한 해부학적으로 정상 심장을 가진 총 18명의 소아들을 대상으로 본 연구를 시행하였다. 심첨 4방 단면도에서 이완기 승모판 유입 최고 혈류 속도 E, A와 승모판륜의 외측 끝단 및 심실 중격 끝단에서 조직 도플러 영상으로부터 s',e',a'과 함께 각각의 심장 주기 시간을 측정하였다. 모든 측정은 연속된 6-18 심장 주기 동안 이루어졌으며, 심장 주기 길이와 각 지표들 간의 연관성을 조사하였다. 결 과 : 평균 나이는 $3.6{\pm}0.5$세(남:여=8:10)이었다. 심장 주기 시간과 Lat s', Lat a', Sep s', Sep e', Sep a'은 음의 상관관계를 보였다(P<0.01). 심장 주기 시간과 E/A, Lat e'/a', Sep e'/a'은 양의 상관 관계를 보였다(P<0.01). 그러나 E, Lat e'은 통계학적으로 유의한 상관관계를 보이지 않았다(P=0.229, 0.221). 결 론 : 본 연구로 심장 주기 시간의 변화에 따라 좌심실 기능을 나타내는 지표들이 변화함을 알 수 있었다. 따라서 소아에서 정상치를 결정함에 있어 이러한 변화를 고려하여야 한다.

Keywords

Acknowledgement

Supported by : Ulsan University

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