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Normalization of Cardiac Structural dimension and Function to Body Surface Area in South East Nigeria Children
J M Chinawa1, A T Chinawa2, F A Ujunwa1
1Department of Paediatrics, College of Medicine, University of Nigeria Ituku/Ozalla and University of Nigeria Teaching Hospital Ituku/Ozalla Enugu State, Nigeria.
Insights
Standardizing cardiac measurements using Z-scores in children provides crucial reference values. These findings align with Western standards, with minor exceptions for mitral valve and pulmonary artery dimensions.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
- Clinical Measurement
Background:
- Standardizing cardiac valve structures and function to body surface area is essential for clinical and surgical decision-making.
- Accurate pediatric cardiac assessment requires age- and size-appropriate reference values.
Purpose of the Study:
- To evaluate Z-scores for cardiac structure and function in healthy children.
- To establish Gaussian curves and reference values for pediatric cardiac parameters.
Main Methods:
- A cross-sectional study involving 300 healthy children aged 0-18 years.
- Inclusion criteria: normal echocardiogram, no chronic or congenital/acquired heart defects.
- Cardiac structures and function were assessed, and Z-scores were calculated.
Main Results:
- The majority of cardiac structure and function Z-scores fell within normal limits, visualized by Gaussian curves.
- Minor deviations observed: 13.3% of atrioventricular valve diameters were +1 Z-score above normal; 9.3% were below -2 Z-score.
- Left ventricular function Z-scores ranged from -3 to +3; no significant difference from standard values, except for mitral valve and left pulmonary artery dimensions (P=0.02).
Conclusions:
- Reference values for pediatric cardiac structure and function were established using Z-scores.
- These values showed no significant difference compared to Western standards, with noted exceptions for the mitral valve and left pulmonary artery.
Background:
Standardizing cardiac valve structures and function to body surface area will help the clinician and surgeons in decision-making.
Aim:
To evaluate the z-scores of the sizes of cardiac structures and function and to present them in Gaussian curves and reference values.
Materials And Methods:
This was a cross-sectional study that involved 300 apparently healthy children. This study was performed among healthy children from birth to 18 years. Children with a normal echocardiogram, those with no chronic illness, no congenital heart defect, and no acquired heart defect were included in the study.
Result:
The majority fell within the normal limits, as shown in the Gaussian curves. For instance, 40 (13.3%) of atrioventricular (AV) valve diameters were +1 Z-score above the normal, and only 5 (1.7%) were +2 Z-score above the normal. About 9.3% (28/300) had below -2 Z-score below normal, while only 5% had -1 Z-score below normal. Similarly, the left ventricular function z-scores were also derived at -3 Z-scores to +3 Z-scores. The standard reference values were compared with the results obtained from our Z score values. There was no significant difference noted in the Z-scores. P values ranged from 0.07 to 0.84 for all the cardiac structures except for gender, where Z-scores of the mitral valve and left pulmonary artery varied significantly (P = 0.02).
Conclusion:
Reference values of cardiac structure and function were presented using Z scores, and we noted no significant difference when compared with the Western standard values except for the mitral valve and left pulmonary artery.
