The evaluation of diastolic function is very important carrying prognostic informations. While in adults there are guidelines and statements in children there are less evidence. So in your clinical practice how do you assess diastolic evaluation in children? Which parameters and which cut off values do you use?
usually we use doppler mitral E/A TDI lateral and medial IVRT and IVCT both of left and right ventricle. We have adults value too but these measurements are exspecially valid in longitudinal repeated measurements in the same child or newborn to assess improving or worsening of diastolic funtion
Hi Giovanni,
This is notoriously difficult as adult standards are of little help.
What you need to find or to develop are normal age-related values.
Then you could go and measure E/a and e' at the medial and lateral annulus. You should also carefully meaure and scale LA volume. I wouldn't relie on E/e' as it is not a reliable marker of filling pressures in normals and in younger subjcts.
Maybe someone else could give you the insight of an experienced paediatrician in this very issue.
Wishes,
thierry
I completely agree with Thierry. Determination of normal values of diastolic parameters is crucial issue in children also in relation to heart rate, which can be higher in the childhood. Reference normal values can be of great help to identify an abnormal diastolic function in children.
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