Evaluation of pulmonary hypertension by M-mode echocardiography in children with ventricular septal defect.

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Abstract
The ratio of the right ventricular preejection period to the right ventricular ejection time (RVPEP/RVET) as a predictor of pulmonary hypertension in 16 children with ventricular septal defects (VSD) (group 1) was evaluated. The children ranged in age from 5 mo.-18 yr. The RVPEP/RVET was measured at the time of cardiac catheterization my M-mode echocardiography from the pulmonary valve echogram and from a simultaneously displayed pulmonary arterial pressure signal obtained with a microtip, manometric catheter. The RVPEP/RVET measured by both methods was comparable (r [correlation coefficient] = 0.91). The RVPEP/RVET was compared with the pulmonary artery diastolic pressure (PADP) (r = 0.54). The RVPEP/RVET ratio correlated less well with the pulmonary arterial mean pressure and pulmonary vascular resistance. In a 2nd group of 51 children with VSD, echocardiographic measurement of the right ventricular systolic time intervals was performed within 24 h before cardiac catheterization. The same variables of pulmonary arterial pressure as for group 1 were compared with the RVPEP/RVET ratio, and the results were similar. Although there is a relationship between the RVPEP/RVET and pulmonary hypertension, the ratio alone is evidently not accurate enough to avoid cardiac catheterization in patients considered at risk for pulmonary vascular disease.