Dopplerographic Time-Interval T(E-Ea) in Evaluation of Left Ventricular Diastolic Function in Children with Acute Lymphoblast Leucosis During Polychemotherapy

We have shown previously that reflected high intensity motion signals (RIMS) registered by conventional pulsed wave Doppler can be utilized for detection of left ventricular diastolic dysfunction (DD). In this study, we decided to analyze if new dopplerographic time interval parameter T(E-Ea) (time between onset of peak E of transmitral flow and onset of peak Ea of RIMS) can help in detection of initial cardiotoxic effect of polychemotherapy in the form of mild DD in children with acute lymphoblast leukosis. Pulsed wave dopplerography was performed in 47 healthy children and 94 children with acute lymphoblast leukosis during polychemotherapy. Cardiac probe was placed in an apical position and the sample volume was moved between the tips of mitral leaflets. Sensitivity and diagnostic efficacy of T(E-Ea) and traditional transmitral ratio E/A in the detection of DD were compared. Normal value of T(E-Ea) was 20.4 ± 8.5 ms. The analysis revealed that conventional cutoff value of E/A < 1.0 and cutoff value of new parameter T(E-Ea) > 28 ms can separate children with and without mild DD with sensitivity 4.3 and 74.5% (p < .00001) and diagnostic efficacy of 36.2 and 78.0% (p < .00001), respectively. New dopplerographic time interval T(E-Ea) can detect cardiotoxic drug effects in the form of mild diastolic disturbances in children with acute lymphoblast leukosis during polychemotherapy. New Doppler parameter is much more sensitive in detection of diastolic disturbances than traditional E/A ratio.