The characteristics of the spectra of superior venae cavae in patients with right heart failure

BACKGROUND: Aimed to elucidate the characteristics of the spectra of superior venae cavae (SVC) in respiratory cycles in patients with right heart failure. METHODS: The spectra of SVC of 30 patients with right heart failure and 30 paired healthy subjects were recorded through right supraclavicular fossa view. The profiles of spectra of superior venae cavae were observed, and peak velocity and velocity time integral (VTI) of every wave of SVC under spontaneous respiration were measured for statistical analysis. RESULTS: In healthy subjects, the peak velocities and VTI of S wave and D wave increased in inspiratory phase and diminished in expiratory phase, and which of S wave were larger than which of D wave in whole respiratory cycle. In patients with right heart failure, spectral variations of SVC could be classified into three patterns: Pattern I: peak velocities and VTI of S wave were larger than that of D wave in early inspiratory phase, but peak velocities and VTI of D wave were larger than those of S wave in late inspiratory phase and early expiratory phase [Pattern I-1], even in whole respiratory cycle [Pattern I-2]; Pattern II: the S wave disappeared and was substituted by inverse wave with low amplitude in whole respiratory cycle. Pattern III: the profiles of the spectra of SVC in patients were similar to those of healthy subjects. In the whole, the respiratory variation ratios of peak velocities and VTI of S wave and D wave were diminished in patients compared with those in healthy subjects. CONCLUSION: The spectra of superior venae cavae in patients with right heart failure were abnormal, and these characteristics could be used as signs in evaluating right heart failure

Reference intervals for the echocardiographic measurements of the right heart in children and adolescents: a systematic review

BACKGROUND: Transthoracic echocardiography is the primary imaging modality for the diagnosis of right ventricular (RV) involvement in congenital and acquired heart diseases. There is increasing recognition of the contribution of RV dysfunction in heart diseases affecting children and adolescents, but there is insufficient information on reference intervals for the echocardiographic measurements of the right heart in children and adolescents that represent all the continental populations of the world.OBJECTIVE:The aim of this systematic review was to collate, from published studies, normative data for echocardiographic evaluation of the right heart in children and adolescents, and to identify gaps in knowledge in this field especially with respect to sub-Saharan Africans. METHODS: We performed a systematic literature search to identify studies of reference intervals for right heart measurements as determined by transthoracic echocardiography in healthy children and adolescents of school-going age. Articles were retrieved from electronic databases with a combination of search terms from the earliest date available until May 2013. RESULTS: Reference data were available for a broad range of variables. Fifty one studies out of 3096 publications were included. The sample sizes of the reference populations ranged from 13 to 2036 with ages varying from 5 to 21 years. We identified areas lacking sufficient reference data. These included reference data for determining right atrial size, tricuspid valve area, RV dimensions and areas, the RV % fractional area change, pulmonary artery pressure gradients and the right-sided haemodynamics, including the inferior vena cava dimensions and collapsibility. There were no data for sub-Saharan African children and adolescents. CONCLUSION: Reliable reference data are lacking for important echocardiographic measurements of the RV in children and adolescents, especially for sub-Saharan Africans