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Mitral valve E point to ventricular septal separation in infants and children
Insights
This study provides normal values for mitral valve E point to ventricular septal separation (EPSS) in children. These measurements help assess left ventricular function in pediatric echocardiography.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Cardiac Physiology
Background:
- The mitral valve E point to ventricular septal separation (EPSS) is an echocardiographic measurement.
- Establishing normative data for EPSS is crucial for its clinical application in pediatric populations.
- Previous studies lacked comprehensive norms for infants and children.
Purpose of the Study:
- To establish normative values for EPSS and normalized EPSS (EPSS/EDD) in healthy infants and children.
- To evaluate the utility of EPSS as an ejection phase index for assessing left ventricular (LV) function in pediatric patients.
- To determine the correlation of EPSS and EPSS/EDD with age, body size, and LV volume/function.
Main Methods:
- Echocardiographic measurements of EPSS and end-diastolic dimension (EDD) were obtained from 105 normal subjects (1 day to 15 years).
- EPSS/EDD ratio was calculated to normalize for variations in cardiac size.
- Data were compared between normal subjects and patient groups with increased LV volume (ventricular septal defect, patent ductus arteriosus) and depressed LV function (dilated cardiomyopathy).
Main Results:
- In normal subjects, mean EPSS was 2.5 ± 1.7 mm and mean EPSS/EDD was 0.08 ± 0.06.
- These values showed no significant correlation with age, body surface area, height, or weight.
- Patients with dilated cardiomyopathy exhibited significantly increased EPSS (16.5 ± 5.1 mm) and EPSS/EDD (0.39 ± 0.09) compared to normal subjects and those with volume overload.
- Patients with ventricular septal defect or patent ductus arteriosus had EPSS and EPSS/EDD similar to normal controls.
Conclusions:
- Normative data for EPSS and EPSS/EDD in infants and children have been established.
- EPSS and EPSS/EDD are reliable indicators of left ventricular function, independent of age and body size.
- These echocardiographic indexes offer a simple, practical, and accurate method for differentiating normal from abnormal LV function in pediatric echocardiography.
Abstract:
This investigation establishes heretofore unavailable norms that permit clinical application of mitral valve E point to ventricular septal separation (EPSS) as an ejection phase index in infants and children. The study consisted of 105 normal subjects (1 day through 15 years of age, mean 7.4 years) and 67 patients of comparable age. Fifty-seven patients had increased left ventricular (LV) volume with normal function (ventricular septal defect or patent ductus arteriosus) and 10 patients had increased LV volume with depressed function (dilated cardiomyopathy). In normal subjects, EPSS was 2.5 +/- 1.7 mm and "normalized" EPSS, that is, the ratio of EPSS to end-diastolic dimension (EPSS/EDD), was 0.08 +/- 0.06 (mean +/- standard deviation); there was no correlation between either of these indexes and age, body surface area, height or weight. In patients with ventricular septal defect or patent ductus arteriosus, or both, the EPSS and EPSS/EDD were similar to those of normal subjects (3.2 +/- 2.3 mm and 0.09 +/- 0.06 mm, respectively). In patients with dilated cardiomyopathy, these indexes were significantly increased (p greater than 0.05) (EPSS 16.5 +/- 5.1 mm; EPSS/EDD 0.39 +/- 0.09). The data provide normal values for EPSS and EPSS/EDD in infants and children and show that these indexes are independent of age, body surface area, height or weight. Mitral valve EPSS and EPSS/EDD can now be used in pediatric echocardiography as a simple, practical and accurate means of separating normal from abnormal LV function.