الفهرس 
Aortic tissue velocities in patients with coarctation vs patients with ventricular septaldefects
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Abstract
Rational and background: Congenital heart disease is the most common congenital disorder in
newborns. They account for about thirty percent of all major birth defects. CHD is one of the
leading causes of perinatal and infant death from congenital malformations.
Aim of the work: Compare Tissue velocity between cases of congenital heart disease with volume
overload and congenital heart disease With pressure over load to detect discrepant myocardial
responses to pressure and volume overload.
Subject and methods: This study was carried out on 60 children at pediatric cardiology department
in Kasr-al-ainy hospital, 39 of them were diagnosed to have congenital heart diseases.19 of them
suffer from VSD and 20 suffer from CoA. Also another 21 normal children were taken as a control
group. All the patients had Full history taking, clinical examination, laboratory investigations in the
form of kidney function tests (urea & creatinine) & urine analysis, calculation of the estimated GFR
and Echocardiographic assessment for calculation of the Left Ventricular E/E‘ (Left Ventricular
ratio of early diastolic mitral inflow velocity to average of early diastolic velocities of the mitral
annulus and basal septum) as a potential measure of LV diastolic function
Results: Patient groups of VSD and CoA show low body weight and failure to thrive in comparison
to control group. According to echocardiographic findings, it was found that Systolic tissue
velocities (Septal S & Mitral S) are significally higher in the group of VSD patients in comparison
to the other groups. Also the LV E/E’ ratio was significantly elevated in CoA group rather than
other groups, denoting more affection of LV E’ (tissue Doppler in mitral annulus) in CoA group.
Mean LVSd (LV end diastolic septum thickness) is significantly affected in CoA group rather than
control group and VSD and normal at VSD versus control group.Mean LV GLS (SYSTOLIC
FUNCTION) is reduced in both VSD and CoA groups but significantly affected in CoA group
rather than VSD group. There was strong positive correlation between Septal S and VSD size and
strong negative correlation between LV E/E’ and VSD size. There was very strong positive
correlation between LV E/E’ and Pressure gradient across CoA and very strong negative correlation
between Mitral annular S and Pressure gradient across CoA. There is a significant increase in GFR
in patient with VSD in comparison to CoA patients, but GFR showed no significant correlation with
VSD size
Conclusion: Systolic LV velocities were markedly impaired in coarctation group compared to VSD
group, which had even higher systolic velocities than control group. Diastolic function was found to
be highly impaired in cases with pressure load such as coarctation compared to patients with VSD.
This should guide tailoring Anti-failure therapy in each of those conditions