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Updated: Jul 9, 2026
Murine Fetal Echocardiography
Published on: February 15, 2013
Comparison of ejection phase indices of left ventricular performance in infants and children
Insights
Heart rate impacts left ventricular performance metrics like mean velocity of circumferential fiber shortening (mVcf). A compensated mVcf (A/E) effectively identifies myocardial dysfunction in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Cardiac Physiology
- Diagnostic Imaging
Background:
- Left ventricular myocardial performance is crucial for assessing cardiac health in children.
- Traditional ejection phase indices like mean velocity of circumferential fiber shortening (mVcf), mean systolic ejection rate (mSER), and ejection fraction (EF) are used.
- Heart rate variability can influence these measurements, potentially affecting diagnostic accuracy.
Purpose of the Study:
- To evaluate the diagnostic utility of ejection phase indices for pediatric myocardial performance.
- To assess the impact of heart rate on these indices and introduce a heart rate compensation method.
- To determine the superiority of a compensated index in identifying myocardial dysfunction.
Main Methods:
- Left ventricular cineangiograms were analyzed in 248 pediatric patients.
- Ejection phase indices including mVcf, mSER, and EF were calculated.
- A heart rate compensation method (A/E ratio) was applied to mVcf.
Main Results:
- Heart rate significantly correlated with mVcf and mSER in normal subjects.
- All indices were lower in patients with myocardial disease compared to normal controls.
- Compensated mVcf (mVcf A/E) provided complete separation between normal and myocardial disease groups.
- Left ventricular volume overload showed reduced mVcf and mVcf (A/E).
- Patent ductus arteriosus was associated with elevated mVcf and mSER.
Conclusions:
- Compensated mVcf (A/E) is a superior index for identifying depressed myocardial performance in pediatric patients.
- Heart rate compensation is essential for accurate assessment of left ventricular function.
- Ejection phase indices, particularly compensated mVcf, aid in diagnosing various pediatric cardiac conditions.
Abstract:
Ejection phase indices of left ventricular myocardial performance, mean velocity of circumferential fiber shortening (mVcf), mean systolic ejection rate (mSER), and ejection fraction (EF) were determined in 248 pediatric patients, utilizing left ventricular projections of cineangiograms. Heart rate significantly affected mVcf and mSER values in the normal group (r=0.74, 0.79, respectively). A method for heart rate compensation was presented, utilizing a ratio of actual value to expected normal value (A/E) for that heart rate. All indices were significantly lower in the myocardial disease group (12 patients) than in the normal (NI) group (55 patients), but only mVcf (A/E) gave complete separation. There was complete or nearly complete overlap of right ventricular volume and pressure load and left ventricular (LV) pressure load groups (20, 38, and 28 patients each) with NI. For LV volume load (95 patients) mVcf, and mVcf (A/E) mean values were low (P less than 0.025, less than 0.001, resp.). Patients with patent ductus arteriosus had high mVcf and mSER values (P less than 0.05, less than 0.025). MVcf (A/E) was superior to the other indices in identifying patients with depressed myocardial performance.
