Related Experiment Videos
Echocardiographic analysis of regional left ventricular wall motion in normal children and neonates
M Vogel1, J F Smallhorn, J I Stein
1Department of Pediatrics, University of Toronto, Faculty of Medicine, Ontario, Canada.
Insights
This study establishes normal echocardiographic values for regional left ventricular wall motion in pediatric populations. These findings provide a crucial database for detecting abnormalities in children, improving cardiac assessments.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Cardiovascular Imaging
Background:
- Lack of comprehensive normal data for pediatric left ventricular (LV) regional wall motion by echocardiography.
- Observer variability in assessing LV wall motion in neonates and children is not well-defined.
Purpose of the Study:
- To establish normal reference values for regional left ventricular area change in infants and children.
- To assess observer variability in these measurements.
- To create a database for identifying abnormal LV segments in pediatric patients.
Main Methods:
- Echocardiographic assessment of regional area change in 55 healthy neonates, infants, and children.
- Division of the left ventricle into eight segments for percent area change calculation.
- Application of both fixed and floating reference systems, with analysis of parasternal, apical, and subcostal views.
Main Results:
- Established normal values for regional percent area change across eight LV segments in pediatric age groups.
- Intraobserver variability was low (2.8-3.8%), and interobserver variability was 4.7%.
- Results were consistent between reference systems, though imaging plane (subcostal vs. parasternal) influenced findings.
Conclusions:
- Normal echocardiographic values for regional left ventricular wall motion in children have been established.
- This database aids in the early detection of regional LV wall motion abnormalities in pediatric patients.
- The findings are critical for accurate diagnosis and management of pediatric heart conditions.
Abstract:
Because comprehensive normal data and the effect of observer variability for echocardiographic evaluation of regional left ventricular wall motion are not available in children or newborns, left ventricular wall motion was assessed by measuring regional area change. The study group comprised 55 infants and children with a normal heart: 15 neonates (greater than 1 week to less than 1 month old), 10 infants (greater than 1 month to less than 1 year old) and 30 children, 10 each in the age group greater than 1 year to less than 5 years, greater than 5 to less than or equal to 10 years and greater than 10 years. A combination of parasternal, apical and subcostal two-dimensional echocardiographic views was applied. After planimetry of an end-systolic and end-diastolic frame, the left ventricle was divided into eight equal segments and the percent area change calculated. Both a fixed reference and a floating system correcting for translation and rotation were applied. Intraobserver variability for percent area change measurements was 2.8 +/- 0.9% and 3.8 +/- 1% for observers 1 and 2, respectively. The mean interobserver difference of regional percent area change was 4.7 +/- 1.8%. Normal values for the eight anatomic segments were established in each echocardiographic imaging plane. The overall results were independent of the type of reference system utilized. The subcostal views yielded different results from their parasternal counterparts, probably because of differing imaging planes. These normal values establish a data base in the pediatric age range that can be used to detect abnormal segments in children at risk for developing regional left ventricular wall motion abnormalities.