Echocardiographic assessment of cardiac growth in children with structurally normal hearts

Area of Science:

• Pediatric Cardiology
• Developmental Biology
• Biometrics

Background:

• Early childhood is crucial for cardiac development.
• The influence of prenatal factors and early growth on heart structure in healthy children is not fully understood.
• This study examines how birth weight, gestational age, and weight gain affect cardiac dimensions.

Purpose of the Study:

• To investigate the association between birth characteristics (birth weight, gestational age, BW/GA z-score) and postnatal weight gain (weight gain z-score) with cardiac dimensions in children.
• To determine the relative importance of prenatal vs. postnatal growth factors on cardiac structure.

Main Methods:

• Longitudinal analysis of 1000 echocardiograms from 738 children (11-83 months).
• Standardized cardiac dimensions and volumes using z-scores for body surface area (BSA).
• Analyzed birth weight (BW), gestational age (GA), BW/GA z-score, and weight gain z-score as predictors.

Main Results:

• Higher weight gain z-score was independently associated with smaller cardiac dimension z-scores (aortic root, ascending aorta, left atrium, left ventricle dimensions, and mass).
• Postnatal weight gain was a more significant predictor of cardiac size than birth characteristics.
• Ejection fraction and fractional shortening were not significantly influenced by the studied predictors.

Conclusions:

• Postnatal weight gain is more consistently linked to cardiac structure z-scores than birth anthropometrics.
• Vascular cardiac structures showed inverse scaling with higher weight gain, while myocardial thickness remained stable.
• Early growth patterns, particularly weight gain, play a significant role in shaping cardiac dimensions during childhood.