Echocardiographic Reference Ranges of Non-invasive Myocardial Work Indices in Children

Area of Science:

• Pediatric Cardiology
• Echocardiography
• Cardiovascular Physiology

Background:

• Global myocardial work (GMW) is an emerging echocardiographic method for assessing left ventricular (LV) function.
• It offers potential advantages over traditional measures like ejection fraction (EF) and global longitudinal strain (GLS).
• Feasibility and reference ranges for GMW in pediatric populations require establishment.

Purpose of the Study:

• To determine the feasibility and reproducibility of echocardiographic-derived GMW in healthy children.
• To establish normal reference values for GMW indices in this population.
• To investigate the influence of age, gender, and clinical factors on GMW reference ranges.

Main Methods:

• Prospective enrollment of 212 healthy children (median age 9 years, 112 female).
• Measurement of global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) using LV pressure-strain loops.
• Quantification performed on a GE Vivid E95 system with Echopac software.

Main Results:

• GMW indices demonstrated good intra-observer and inter-observer reproducibility.
• No significant differences in GMW indices were found across age groups or genders.
• GWI and GCW correlated significantly with GLS and systolic blood pressure, with GWI and GCW showing closer correlation to systolic blood pressure than GLS.

Conclusions:

• Echocardiographic GMW is feasible and reproducible in healthy children.
• This study provides the first reference ranges for non-invasive echocardiographic GMW indices in children.
• GMW serves as a complementary modality for assessing pediatric LV performance.