Left Atrial Volumes and Phasic Function in Healthy Children: Reference Values Using Real-Time Three-Dimensional...

Area of Science:

• Pediatric Cardiology
• Echocardiography
• Cardiac Imaging

Background:

• Left atrial (LA) size and function are crucial in pediatric cardiac diseases.
• Real-time three-dimensional echocardiography (3DE) provides noninvasive assessment of cardiac volumes and function.
• Establishing pediatric reference values for LA 3DE is essential for accurate diagnosis and management.

Purpose of the Study:

• To establish pediatric reference values for left atrial (LA) 3DE volumes and phasic function.
• To analyze a large cohort of healthy children for normative data.
• To provide a basis for evaluating LA function in pediatric cardiac patients.

Main Methods:

• Prospective analysis of 432 pediatric LA data sets (0-222 months) using vendor-independent software.
• Assessment of LA volumes (Vmax, Vmin) and phasic function (active and passive emptying fraction [EF]).
• Calculation of sex-specific reference values, percentiles, and z-scores using the LMS method.

Main Results:

• Absolute LA volumes increased with age and body surface area.
• Active EF and atrial emptying duration showed trends with R-R intervals; passive EF decreased.
• 3DE demonstrated very good reproducibility for LA volumes, with good correlation to cardiac MRI, despite known underestimation.

Conclusions:

• 3DE reliably measures pediatric LA volumes and phasic function.
• The established pediatric reference values support LA evaluation by 3DE.
• These reference values aid in detecting LA dysfunction and monitoring congenital heart disease patients.