JDMS CME Article-SDMS CME Credit

Article: Comparison of Current Echocardiographic Modalities Used to Assess Left Ventricle Diastolic Function in Pediatric Patients

Authors: Lisa L. Cordell, BS, RDCS

Category: Cardiac/Pediatric Cardiac

Credit: 1.0 SDMS CME Credit

Objectives: After studying the article entitled “Comparison of Current Echocardiographic Modalities Used to Assess Left Ventricle Diastolic Function in Pediatric Patients,” you will be able to:

1. Apply tissue Doppler imaging to evaluate pediatric cardiac function

2. Measure color M-mode velocity propagation during early diastolic filling

3. Use speckle tracking for deformation imaging to determine strain rate

1. Deformation imaging measures the twisting of the myocardium in the

2. Radial dimension

3. Circumferential dimension

4. Longitudinal, radial, and circumferential dimensions

Color M-mode velocity propagation measures blood velocity filling the left ventricle during diastole to evaluate

Left ventricular contractility

Left atrial pressure

Left ventricular relaxation

Systemic vascular resistance

Tissue Doppler imaging measures peak myocardial velocities during

Early diastolic filling

Early and late diastolic filling

Early systolic contraction

Late systolic contraction

In pediatric patients older than one year, the variability in tissue Doppler imaging velocity measurements has been reported to be approximately

2%–5%

5%–8%

8%–11%

10%–15%

A relative advantage to color M-mode velocity propagation measurement is that

It is acquired in one image

It is load dependent

It normalizes with progressing diastolic dysfunction

It is measured from multiple velocities obtained at different depths

Variability in deformation imaging measurements has been reported to be approximately only

1%–2%

2%–4%

4%–10%

10%–15%

Mitral valve blood inflow velocities should be measured

Using an apical four-chamber view with the Doppler sample volume placed in mid-ventricle

Using an apical four-chamber view with the Doppler sample volume placed at the mitral valve leaflet tips

Using a parasternal long-axis view with the Doppler sample volume placed in mid-ventricle

Using a parasternal long-axis view with the Doppler sample volume placed in mid-atrium

For accurate speckle tracking imaging in pediatric patients, the frame rate should be kept between

20 and 40 frames per second

40 and 50 frames per second

50 and 70 frames per second

50 and 90 frames per second

Proper assessment of diastolic function includes evaluation of

Isovolumic relaxation

Early ventricular filling

Late ventricular filling

All of the above

In a study in 2013 by Draculescu et al, it was proposed that a value be considered abnormal if it was greater than _________ outside the published reference value.

One standard deviation

Two standard deviations

Three standard deviations

Four standard deviations