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Updated: Jun 18, 2025
Quantification of Mouse Heart Left Ventricular Function, Myocardial Strain, and Hemodynamic Forces by Cardiovascular Magnetic Resonance Imaging
Published on: May 24, 2021
Pediatric reference values for myocardial contraction fraction and global function index of the left ventricle: A
Inga Voges1, Berit Henke2, Piers E F Daubeney3
1Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital Schleswig-Holstein, Kiel, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Greifswald/Kiel/Lübeck, Kiel, Germany.
Insights
This study establishes pediatric reference values for left ventricular global function index (LVGFI) and myocardial contraction fraction (LVMCF) using cardiovascular magnetic resonance (CMR). These new cardiac function markers show significant age-related changes in children and adolescents.
Area of Science:
- Cardiology
- Medical Imaging
- Pediatric Health
Background:
- Cardiovascular magnetic resonance (CMR) derived global function index (GFI) and myocardial contraction fraction (MCF) are valuable for assessing left ventricular (LV) performance and prognosis.
- Pediatric reference values for these markers are currently lacking.
Purpose of the Study:
- To establish normative pediatric reference values for LVGFI and LVMCF.
- To analyze the relationship of these markers with age and other demographic factors in children and adolescents.
Main Methods:
- Retrospective analysis of 154 CMR examinations from healthy children and adolescents (4-18 years).
- Measurement of LV volumes, ejection fraction (LVEF), and myocardial mass.
- Calculation of LVGFI and LVMCF, with statistical analysis using the Lambda-Mu-Sigma (LMS) method for percentile curves.
Main Results:
- Mean LVGFI was 46.3% and mean LVMCF was 110.6%.
- Both LVGFI and LVMCF decreased significantly with age (p < 0.001).
- Strong correlations were found between LVGFI and LVMCF (r=0.78) and between LVGFI and LVEF (r=0.80).
Conclusions:
- Pediatric CMR reference values for LVGFI and LVMCF have been established.
- These reference values can enhance the interpretation of clinical CMR studies in pediatric populations.
- The findings support the use of LVGFI and LVMCF as important functional markers in pediatric cardiology research.
Background:
Cardiovascular magnetic resonance (CMR) derived global function index (GFI) and myocardial contraction fraction (MCF) were identified as useful imaging markers to assess left ventricular (LV) cardiac performance and can provide prognostic information for several cardiac diseases. As pediatric reference values are lacking, the aim of this retrospective study was to establish these values.
Methods:
154 CMR examinations of healthy children and adolescents (4-18 years) were included. LV end-diastolic, end-systolic and stroke volumes, ejection fraction (LVEF) and myocardial mass were measured using short axis stacks. Results were used to calculate LVGFI and LVMCF. Statistically, the Lambda-Mu-Sigma (LMS)-method was applied to create percentile curves and tables.
Results:
The mean age (standard deviation) of the subjects was 13.8 (2.8) years, 102 were male (66%). Mean LVGFI was 46.3 (6.0)% and mean LVMCF was 110.6 (19.9) %. Both, LVGFI and LVMCF decreased significantly with age (LVGFI: r = -0.30, p < 0.001; LVMCF: -0.30, p < 0.001). There was no statistical difference between girls and boys (p all >0.05). Strong correlations between LVGFI and LVMCF (r = 0.78, p < 0.001) as well as between LVGFI and LVEF (r = 0.80, p < 0.001) were documented whereas the correlation of LVMCF and LVEF was weaker (r = 0.32, p < 0.001). Univariable and multivariable regression analysis demonstrated that LVGFI was strongly associated with age whereas LVMCF was associated with weight. Percentile curves and tables were created accordingly.
Conclusion:
We provide pediatric CMR reference values for the new cardiac functional markers LVGFI and LVMCF. These may improve the interpretation of clinical CMR studies and can be used for future research studies.
