Height Versus Body Surface Area to Normalize Cardiovascular Measurements in Children Using the Pediatric Heart...

Area of Science:

• Pediatric Cardiology
• Biometry
• Medical Imaging Analysis

Background:

• Accurate normalization of cardiovascular measurements is crucial for comparing children and identifying pathological changes.
• Growing interest exists in utilizing height for normalizing pediatric cardiovascular data.
• Body surface area (BSA) has been the traditional method for normalization.

Purpose of the Study:

• To develop and compare height-based normalization models with BSA-based models for aortic and left ventricular (LV) measurements in children.
• To evaluate the impact of different normalization methods on Z-scores across varying body mass index (BMI) categories.

Main Methods:

• Utilized echocardiographic data from healthy children aged 2-18 years from the Pediatric Heart Network Echo Z-Score Project.
• Calculated Z-scores for proximal aortic diameters, LV end-diastolic volume, and LV mass using both height-based and BSA-based allometric normalization.
• Assessed relationships between Z-scores and demographic factors (age, sex, race, ethnicity) and BMI.

Main Results:

• Height-based and BSA-based normalization models for aortic and LV sizes are feasible in children.
• No significant relationships were found between Z-scores and age, sex, race, or ethnicity.
• Height-based normalization yielded lower Z-scores in underweight children and higher Z-scores in overweight children compared to BSA-based normalization.

Conclusions:

• Both height and BSA normalization are viable for pediatric cardiovascular measurements.
• Height-based normalization leads to higher Z-scores in heavier children, while BSA-based normalization favors lighter children.
• Further research is needed to validate these methods in obese children, with and without cardiac conditions.