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Echocardiographic Normal Reference Ranges for Non-invasive Myocardial Work Parameters in Pediatric Age: Results From
Jolanda Sabatino1,2,3,4,5,6, Isabella Leo3, Antonio Strangio3
1Division of Paediatric Cardiology, Department of Women's and Children's Health, University Hospital Padua, Padua, Italy.
Insights
Non-invasive myocardial work (MW) parameters are feasible and reliable in children. This study establishes normal reference ranges for these echocardiographic indices in the pediatric population, aiding clinical assessment.
Area of Science:
- Pediatric cardiology
- Echocardiography
- Cardiovascular physiology
Background:
- Echocardiography is crucial for pediatric cardiac assessment.
- Non-invasive myocardial work (MW) parameters offer valuable insights into cardiac function.
- Establishing reference ranges in children is essential for accurate interpretation.
Purpose of the Study:
- To assess the feasibility and reliability of non-invasive MW parameters in children.
- To provide normal reference ranges for MW indices in the pediatric population.
- To validate MW parameters as a useful echocardiographic tool for pediatric patients.
Main Methods:
- Retrospective multi-center study of 150 healthy children and adolescents.
- Echocardiographic examination including global longitudinal strain (GLS).
- Calculation of non-invasive MW parameters (GWI, GCW, GWW, GWE) using LV strain loops and brachial artery pressure.
Main Results:
- Feasibility and good inter-/intra-observer reproducibility of non-invasive MW parameters were demonstrated.
- Normal reference ranges for GWI, GCW, GWW, and GWE were established for males and females.
- Significant associations found between GWI/GCW and systolic blood pressure (SBP) and GLS.
Conclusions:
- Non-invasive MW parameters are feasible and reliable in the pediatric population.
- This study provides essential normal reference ranges for pediatric echocardiography.
- MW parameters represent a valuable, non-invasive tool for assessing cardiac function in children.
Aims:
This international multi-center study aimed to demonstrate the feasibility and reliability of non-invasive myocardial work (MW) parameters in the pediatric population, and to provide normal reference ranges for this useful echocardiographic tool in this specific subset of patients.
Methods And Results:
In this retrospective multi-center study involving three pediatric laboratories, 150 healthy children and adolescents (mean age of 10.6 ± 4.5, 91 males) were enrolled. A complete echocardiographic examination has been performed, including global longitudinal strain (GLS) assessment. The following parameters of non-invasive MW have been obtained through a dedicated software: global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE), using left ventricular (LV) strain loops and non-invasive brachial artery cuff pressure values. The lowest expected values were for GWI 1,723 mmHg% in males and 1,682 mmHg% in females, for GCW 2,089 and 2,106 mmHg%, for GWE 95.9 and 95.5% whereas the highest expected value for GWW was 78 mmHg% in men and 90 mmHg% in women. The univariable and multivariable analysis showed significant associations between either GWI or GCW with SBP (β coefficient = 0.446, p < 0.001; β coefficient = 0.456, p < 0.001, respectively) and LV GLS (β coefficient = -0.268, p = 0.001; β coefficient = -0.233, p = 0.003, respectively). Inter- and intra-observer variability showed good reproducibility of non-invasive MW parameters.
Conclusion:
Non-invasive MW parameters were feasible and reliable in the pediatric population. This study provided normal reference ranges of these useful echocardiographic indices.
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