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Cardiac hypertrophy in the developing heart
P E Lange1, D G Onnasch, P H Heintzen
1Department of Pediatric Cardiology and Bioengineering, University of Kiel, F.R.G.
Insights
This study analyzed cardiac growth in children, finding that ejection fraction (EF), muscle volume index (MVI), and cardiac index (CI) are key age-independent indicators of heart function under various loads.
Area of Science:
- Pediatric Cardiology
- Physiologic Cardiac Growth
- Ventricular Remodeling
Background:
- Understanding postnatal cardiac development is crucial for diagnosing and managing pediatric heart conditions.
- The left ventricle (LV) undergoes significant changes in response to various hemodynamic loads during childhood.
Purpose of the Study:
- To investigate physiologic postnatal cardiac growth in humans.
- To characterize left ventricular (LV) function and structure under different overload conditions in infants, children, and adolescents.
Main Methods:
- Analysis of angiocardiographic volume parameters in pediatric subjects.
- Assessment of end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), muscle volume (MV), and body surface area (BSA).
- Evaluation of Ejection Fraction (EF), muscle volume index (MVI), and cardiac index (CI) in normal and overloaded states.
Main Results:
- Normal hearts grow disproportionally to BSA, with LV and RV ejecting similar SVs at different volumes.
- Pressure-loaded LVs showed elevated MVI and higher EF, while volume-loaded LVs had increased MV but normal MVI and EF.
- EF, MVI, and CI were identified as age-independent parameters for assessing cardiac function across different conditions.
Conclusions:
- Ejection Fraction (EF), Muscle Volume Index (MVI), and Cardiac Index (CI) are reliable, age-independent metrics for evaluating pediatric cardiac function.
- Cardiac growth during postnatal development is overproportional to body surface area.
- Ventricular adaptation to pressure and volume loads influences specific cardiac parameters, offering insights into cardiac health in children.
Abstract:
To gain information on physiologic postnatal cardiac growth in humans and to characterize the left ventricle (LV) when subjected to various types of overload during that period, angiocardiographic volume parameters in infants, children, and adolescents were analyzed. In normal subjects, the relationships between end-diastolic volume (EDV), end-systolic volume (ESV), and stroke volume (SV) of the LV and right ventricle (RV), as well as the muscle volume (MV) of the LV and body surface area (BSA) were best fit by power functions with exponents of between 1.2 and 1.3. The EDV and ESV of the LV were smaller than those of the RV. Ejection Fraction (EF), muscle volume index (MVI = MV/EDV), and cardiac index (CI) were constant. In pressure loaded LVs, the MVI was elevated, and increased with increasing pressure load. The ESV tended to be smaller and EF tended to be higher than normal. There was no correlation between EF and EDV. In volume loaded LVs, MV was increased; the MVI, as well as the EF, was normal. The EDV and ESV were elevated without correlation between EF and EDV. In complete transposition of the great arteries. MVI diminished, increasing within months as a response to pressure underloading and overloading. In all groups, there was a negative correlation between EF and ESV, as well as between EF and the shape parameter elongation in systole. During postnatal growth, the normal heart grows overproportionally with respect to BSA, with the LV ejecting the same SV as the RV at a higher EDV and ESV. EF, MVI, and CI are age-independent parameters for assessment of cardiac function.(ABSTRACT TRUNCATED AT 250 WORDS)