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Pediatric Reference Ranges and Test Characteristics of E-point Septal Separation as a Marker for Left Ventricular

Ethan S Vorel1, Xander Jacquemyn2,3, Joanna S Cohen1

  • 1Department of Pediatrics, Division of Pediatric Emergency Medicine, Johns Hopkins Children's Center.

Pediatric Emergency Care
|April 14, 2025
PubMed

Insights

E-point septal separation (EPSS) reliably identifies left ventricular (LV) systolic dysfunction in children. This point-of-care ultrasound metric shows high accuracy, proving useful in pediatric emergency settings.

Area of Science:

  • Pediatric Cardiology
  • Diagnostic Ultrasound
  • Echocardiography

Background:

  • E-point septal separation (EPSS) is a validated point-of-care ultrasound metric for estimating left ventricular ejection fraction (LVEF) in adults.
  • The diagnostic utility of EPSS in pediatric populations for assessing left ventricular (LV) systolic dysfunction is not well-established.

Purpose of the Study:

  • To evaluate the test characteristics of EPSS as a marker of LV systolic dysfunction in pediatric patients.
  • To establish reference ranges for EPSS in a pediatric cohort.

Main Methods:

  • Retrospective analysis of transthoracic echocardiograms from 600 pediatric patients (≤20 years).
  • EPSS measurements obtained from M-mode parasternal long-axis views.
  • Receiver operating characteristic (ROC) curve analysis to determine diagnostic performance.

Main Results:

  • EPSS correlated with various demographic and clinical parameters in controls but not LVEF.
  • Patients with LV systolic dysfunction exhibited significantly higher EPSS values compared to controls (P<0.01).
  • ROC analysis demonstrated an area under the curve of 0.93, with an optimal cut-off of 6.17 mm, achieving 86% sensitivity and 92% specificity.

Conclusions:

  • EPSS is a reliable ultrasonographic marker for identifying LV systolic dysfunction in pediatric patients.
  • The study suggests potential clinical utility of EPSS in pediatric emergency settings for rapid assessment of cardiac function.
Abstract

Keywords:
EPSSPOCUSleft ventricular dysfunctionpediatric heart failure

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