Doppler flow parameters of left ventricular filling in infants: how long does it take for the maturation of the diastolic function in a normal left ventricle to occur?

• Published in: Pediatric cardiology Vol. 25; no. 5; pp. 482 - 491
• Main Authors: Schmitz, L, Xanthopoulos, A, Koch, H, Lange, P E
• Format: Journal Article
• Language: English
• Published: United States 01.09.2004
• Subjects: Atrial Function; Diastole - physiology; Echocardiography, Doppler, Pulsed; Female; Humans; Infant; Linear Models; Male; Prospective Studies; Reference Values; Stroke Volume; Ventricular Function, Left - physiology
• ISSN: 0172-0643; 1432-1971
• DOI: 10.1007/s00246-003-0605-1

To study the impact of the maturational process of diastolic left ventricular function on trans-mitral Doppler flow parameters. In a survey we examined pulsed-wave Doppler signals and diastolic time intervals from 238 healthy neonates and infants. Using multiple linear regression analysis, we evaluated the impact of physiological determinants on parameter expression. Early-filling and atrial-filling peak velocities, early-filling acceleration and deceleration rates, and the atrial-filling time velocity integral reached a climax within 2 months after birth, while early-filling time velocity integral followed increasing throughout the study period. The isovolumic relaxation time was found to be significantly longer for neonates than for infants older than 2 months. The observed parameter movements could be attributed to changes of stroke volume and mitral valve area for early filling-time velocity integral (R2 = 0.93), and of heart rate, stroke volume, and mitral valve area for early filling peak velocity (R2 = 0.84), and atrial-filling time velocity integral (R2 = 0.65). Isovolumic relaxation time and atrial-filling peak velocity became heart rate dependent not before 3 months after birth. The observed parameter changes are powerful indicators for the maturational process in diastolic function. This process is mainly completed by 3 months of age.