Myocardial Performance Index in Children withVentricular Septal Defect

Overview

The echocardiographicmyocardial performance index as descried byTei has been previously shown to be usefulin assessment of myocardial function in children with congenital heart defects. Authors established normal valuesfor index of myocardial performance for right and left ventricles in 60 children with innocent murmurs, beforeassessing 25 patients with ventricular septal defect. The 60 children with normal cardiovascular anatomy andfunction had a mean left ventricular index of 0.288 (SEM 0.019; 95% CI 0.251 - 0.325) and amean right ventricularmyocardial performance index of 0.208 (SEM 0.012; 95% CI 0.183 - 0.232). The mean value of the left ventricularindex was 0.431 (SEM 0.03, range 0.176 - 0.701; p < 0.01) in the 25 patients with ventricular septal defects. It wasabove the95%confidence interval of the control group in 19 children (76%). The meanvalue of the right ventricularindex was 0.514 (SEM 0.054, range 0.333 - 1.0; p < 0.001). It was above the upper limit of normal in all 25 children(100%). Therewas no difference in the left and right ventricular indices of the 10 children who required antifailuremedication from the 15 asymptomatic children (left ventricle: mean 0.403, SEM 0.035 vs mean 0.450, SEM 0.042;p > 0.5; right ventricle: mean 0.549, SEM 0.084 vs 0.491, SEM 0.073; p > 0.5). Changes of the left and rightventricularmyocardial function, as assessed by themoycardial performance index, may be present in the majorityof children with ventricular septal defects. Standard antifailure treatment with diuretics does not influence thisincidence of abnormal myocardial function.

Key words:
myocardial function, ventricular septal defect, children