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Left ventricular myocardial mass determined by cross-sectional echocardiography in normal newborns, infants, and
M Vogel1, W Staller, K Bühlmeyer
1Department of Pediatrics, Deutsches Herzzentrum, Munich, Federal Republic of Germany.
Insights
This study establishes normal reference values for left ventricular mass in children using cross-sectional echocardiography (CSE). These findings provide crucial data for diagnosing and assessing congenital heart defects in pediatric populations.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Cardiac Physiology
Background:
- Left ventricular muscle mass changes are significant in pediatric congenital heart defects.
- Current data on normal left ventricular mass in children via cross-sectional echocardiography (CSE) is lacking.
- Establishing normative data is essential for accurate diagnosis and prognosis.
Purpose of the Study:
- To determine normal reference values for left ventricular mass in children using CSE.
- To compare different geometric methods for mass calculation.
- To assess the reliability and correlation of CSE measurements.
Main Methods:
- Cross-sectional echocardiography (CSE) was performed on 14 newborns, 12 infants, and 69 children (1.5-17 years) with structurally normal hearts.
- End-diastolic and end-systolic volumes and mass were calculated using area/length and Simpson's rule methods.
- Interobserver variability and correlation with M-mode measurements were analyzed.
Main Results:
- A strong correlation was found between area/length and Simpson's rule methods (r = 0.94).
- Low interobserver variability for end-diastolic (r = 0.99) and end-systolic mass (r = 0.97) was observed.
- CSE measurements showed acceptable correlation for end-systolic and end-diastolic mass (r = 0.88), outperforming M-mode measurements.
Conclusions:
- Cross-sectional echocardiography provides reliable measurements of left ventricular mass in children.
- This study establishes crucial reference data for pediatric cardiac assessment.
- CSE is a valuable tool for evaluating left ventricular mass in children, particularly those with congenital heart defects.
Abstract:
Changes in left ventricular muscle mass may be an important diagnostic or prognostic finding in children with congenital heart defects, but there are no data on normal mass as determined by cross-sectional echocardiography (CSE) in children. Fourteen newborns, 12 infants, and 69 children (1.5-17 years old) with a structurally normal heart were studied. End-diastolic and end-systolic volume and mass were calculated from biplane-paired echocardiographic imaging planes-apical two-chamber and apical four-chamber views-using both an area/length and a Simpson's rule geometric method. Data were compared with M-mode measurements. There was a good correlation between area/length and Simpson's rule method [r = 0.94, standard error (SE) 4 g/m2]. To validate the measurements, interobserver data were gathered and end-diastolic and end-systolic mass measurements were compared. Interobserver variability for the measurements on the echocardiographic recordings was low at 4.8%; for end-diastolic mass the correlation between two observers was r = 0.99 (SE 3.3 g/m2) and for end-systolic mass r = 0.97 (SE 7.6 g/m2). Correlation between end-systolic and end-diastolic mass was acceptable (r = 0.88, SE 5.9 g/m2) for the CSE mass determination, but poor for the M-mode measurements (r = 0.51, SE 20.2 g/m2). Similarly, correlation between M-mode mass and mass estimated by CSE was poor, at r = 0.58 for end-diastolic and r = 0.094 for end-systolic mass.(ABSTRACT TRUNCATED AT 250 WORDS)