Evaluation of Left Ventricle Systolic and Diastolic Functions by Tissue Doppler Echocardiography in Children with Down Syndrome

Background: Tissue Doppler imaging evaluates the ventricular function in both systolic and diastolic assessments.
Objectives: This study aimed to determine the level of cardiac function in children with Down syndrome without structural cardiac lesions using conventional and tissue Doppler echocardiography.
Methods: From September 2013 to August 2014 in Mashhad, Iran, a group of 36 children with Down syndrome aged between 4 months and 19 years without anatomic heart diseasehadtheir ventricular function assessed by both 2D echocardiography and tissue Doppler imaging. The following were measured: velocity of systolic waves (S), traditional Doppler imaging of early diastolic waves (E), traditional Doppler imaging of late diastolic waves (A), tissue Doppler imaging early diastolic waves (E’), and tissue Doppler imaging late diastolic waves (A’) at the mitral and tricuspid valve levels. Other data, such as fractional shortening, heart rate, and ejection fraction, were also measured.
Results: At the time of the examination, the mean age of the participants was 6.4±5.5 years. An association was found between children’s age and the tricuspid A-wave. The A-wave velocity of the tricuspid annulus increased when the body surface area decreased. In addition, compared with the normal subjects, the large age group presented with considerable differences in wave speed, including E, A, and E/E’, at the mitral and tricuspid annulus levels.
Conclusions: Despite the Down syndrome children having an apparently normally structured heart, tissue Doppler imaging reveals different findings than those of normal children. The findings of this modality can be used to explain the reason behind the limited physical functioning of children with Down syndrome and may be considered as predictive factors for future cardiac events in these children.