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The prevalence of valvular regurgitation in children with structurally normal hearts: a color Doppler
1Department of Pediatrics, Bikur Cholim Hospital, Jerusalem, Israel.
Insights
Mild valvular regurgitation is common in children with healthy hearts. Echocardiography revealed that 26.9% of pediatric patients with structurally normal hearts had some form of regurgitation, most frequently affecting the pulmonic valve.
Area of Science:
- Pediatric Cardiology
- Cardiac Imaging
- Valvular Heart Disease
Background:
- Valvular regurgitation can occur in children, even without structural heart abnormalities.
- Understanding its prevalence in this population is crucial for accurate diagnosis and management.
Purpose of the Study:
- To determine the prevalence of valvular regurgitation in children aged 0-14 years with structurally normal hearts.
- To identify which valves are most commonly affected and how prevalence varies with age.
Main Methods:
- Retrospective analysis of 1360 pediatric echocardiographic and Doppler examinations.
- Inclusion criteria: structurally normal hearts.
- Assessment of flow patterns across all four heart valves using Doppler imaging techniques.
Main Results:
- 461 patients (33.9%) had structurally normal hearts.
- Regurgitation was detected in 124 patients (26.9%).
- Pulmonic regurgitation was most common (21.9%), followed by tricuspid (6.3%) and mitral (2.4%). Aortic regurgitation was absent.
- Pulmonic regurgitation prevalence increased with age (p<0.0001).
- 87% of cases were trivial or mild regurgitation.
Conclusions:
- Mild valvular regurgitation is a common finding in children with structurally normal hearts.
- Pulmonic regurgitation is the most prevalent type and its incidence rises with age.
- These findings highlight the importance of Doppler echocardiography in evaluating pediatric cardiac function.
Abstract:
To determine the prevalence of valvular regurgitation in children (from birth to 14 years old) with structurally normal hearts, the records of 1360 consecutive patients referred for echocardiographic and Doppler examination were analyzed. A total of 461 (33.9%) patients were found to have structurally normal hearts. Flow patterns across the four valves were examined by pulsed, continuous-wave, and color Doppler imaging techniques. Regurgitation was detected in 124 (26.9%). Pulmonic regurgitation was most commonly found and was detected in 101 (21.9%) patients, tricuspid regurgitation in 29 (6.3%), and mitral regurgitation in 11 (2.4%). Aortic regurgitation was not found. Regurgitation of one valve occurred in 106 (23.0%) patients and of two valves in 18 (3.9%) patients. No patient had regurgitation of more than two valves. The prevalence of pulmonic regurgitation increased significantly with age (p less than 0.0001), whereas the prevalence of mitral, tricuspid, and bivalvular regurgitation did not change with age. Valvular regurgitation was trivial or mild in 87% of patients. Thus mild valvular regurgitation is commonly found in children with structurally normal hearts.