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Echocardiographically determined left ventricular mass index in normal children, adolescents and young adults
S R Daniels1, R A Meyer, Y C Liang
1Department of Pediatrics, Children's Hospital Medical Center, Cincinnati, Ohio 45229.
Insights
This study establishes new echocardiographic criteria for diagnosing left ventricular hypertrophy in children and adolescents. These findings provide crucial diagnostic and prognostic tools for pediatric cardiovascular disease.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Cardiovascular Physiology
Background:
- Left ventricular hypertrophy (LVH) is a key indicator in pediatric cardiovascular disease.
- Current M-mode echocardiography criteria for LVH in children lack standardization.
Purpose of the Study:
- To establish reliable echocardiographic criteria for diagnosing LVH in children and adolescents.
- To validate a regression equation for calculating left ventricular mass using echocardiography.
Main Methods:
- Studied 334 healthy subjects aged 6-23 years.
- Calculated left ventricular mass using a validated echocardiographic regression equation.
- Validated the formula with autopsy measurements and assessed intra/inter-observer variability.
Main Results:
- The echocardiographic formula for left ventricular mass showed strong correlation with autopsy-derived mass (r=0.89).
- LV mass was significantly associated with gender and strongly correlated with height and body surface area.
- Established 95th percentile criteria for LVH based on mass, BSA, and height for males and females.
Conclusions:
- The developed echocardiographic method and criteria provide a validated approach for assessing LVH in pediatric populations.
- These criteria are essential for accurate diagnosis and prognosis of cardiovascular conditions in children.
Abstract:
Left ventricular hypertrophy is an important diagnostic and prognostic finding in children with cardiovascular disease, but there are currently no well established criteria for its determination by M-mode echocardiography. Three hundred thirty-four subjects, aged 6 to 23 years, who were free of cardiovascular disease were studied. Left ventricular mass was calculated using echocardiographic measurements in a regression equation for left ventricular mass. Intraobserver (r = 0.96, p less than 0.01) and interobserver (r = 0.89, p less than 0.01) variability were low. To anatomically validate the echographic formula for left ventricular mass, left ventricular measurements made at autopsy were inserted into the formula. Mass was then calculated and compared with the actual mass. There was a strong correlation between the calculated and the measured left ventricular mass (r = 0.89, p less than 0.01). Left ventricular mass was not statistically related to race, but it was strongly associated with gender (p less than 0.001). It was strongly correlated with height (r = 0.82 for males, r = 0.71 for females) and body surface area (r = 0.83 for males, r = 0.74 for females). Echocardiographic criteria for left ventricular hypertrophy in children and adolescents, based on the 95th percentile, for left ventricular mass, left ventricular mass corrected for body surface area and left ventricular mass corrected for height are, respectively: 184.9 g, 103.0 g/m2 and 99.8 g/m for males and 130.2 g, 84.2 g/m2 and 81.0 g/m for females.(ABSTRACT TRUNCATED AT 250 WORDS)