Abstract

APARICIO, Octavio et al. Evaluación mediante Ecocardiografia Doppler de la Presión Arterial Pulmonar en niños de Altura (La Paz, Bolivia 3600-4000 m.). Cuad. - Hosp. Clín. [online]. 2007, vol.52, n.2, pp.15-20. ISSN 1562-6776.

Doppler echocardiography estimation of Systolic Pulmonary Pressure has a good correlation with simultaneous invasive mesurements. Previous studies have demonstrated that pulmonary artery pressure is elevated in children at high altitude, some of this children develop hyperreactive pulmonary hypertension. The objetive of this study was to determine the normal data of Systolic Pulmonary Pressure, measured with Doppler Echocardiography, in children at high altitude. The study group included 54 children natives and residents of high altitude (La Paz Bolivia 3600-4000 m.) Children from ages of 3 days to 5 years were enrolled, if the clinical examination was considered normal by a staff cardiologist and Doppler echocardiography examinations ruled out associated organic heart disease. Four groups were defined according to age: group I (N=13) from 3 days to 1 year, group II (N=7) from 1 to 2 year, group III (N=11) from 2 to 3 years, group IV (N=23) from 3 to 5 years. The M mode mean standard dimensions were obtained for all the patients. Values for the systolic pulmonary artery pressure were obtained with continuous doppler using the peak velocity of tricuspid regurgitation, and the simplified Bernoulli equation, to obtain the right ventricular pressure, an estimated 10 mmHg right atrial pressure was added . RESULTS Right ventricular dimension was signifi cantly larger in children at high altitude in all the groups. Average systolic pulmonary artery pressure was: group I: 44mmHg, group II: 52mmHg, group III: 35mmHg, group IV: 42mmHg. Average systolic pulmonary artery pressure was 43mmHg DE+-7,1(range 35-52). Conclusion: Systolic pulmonary artery pressure was significatively higher ( Mild Degree) in children up to 5 years old, at high altitude ( La Paz, Bolivia 3600-4000 m.) as compared with sea level. A significant range of Pulmonary artery pressures were observed in this group of high altitude children. Therefore as suggested by other studies, the present observations also advice that the interpretation of systolic pulmonary artery pressure should consider racial characteristics ,age and level of altitude, as important factors to assess .

Keywords : Evaluacion mediante Ecocardiografia doppler de la presion arterial pulmonar en niños de altura..