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Left ventricular diastolic function in children measured by Doppler echocardiography: normal values and relation with
F A Bu'Lock1, M G Mott, R P Martin
1Department of Paediatric Cardiology, Bristol Royal Hospital for Sick Children.
Insights
Normal left ventricular diastolic function in children varies with growth, not adult values. Doppler echocardiography provides essential data for pediatric cardiac assessments and comparative studies.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Diastolic Function
Background:
- Limited normal data for pediatric left ventricular diastolic function.
- Growing interest in echocardiographic assessment of diastolic function in children.
Purpose of the Study:
- Determine normal values for pediatric left ventricular diastolic function.
- Analyze relationships between diastolic function variables and body surface area (BSA).
Main Methods:
- Pulsed wave Doppler echocardiography used to assess transmitral flow patterns.
- 130 healthy children (2.4 months to 19.6 years) included in the study.
Main Results:
- Centile charts for diastolic function variables plotted against BSA are provided.
- Peak early diastolic filling velocity and atrial filling velocity integral were BSA-independent.
- Most other indices correlated with BSA, some curvilinearly due to heart rate interactions.
Conclusions:
- Pediatric left ventricular diastolic function values change with growth and differ from adult norms.
- Presented data are suitable for size-matched comparative studies in children.
- Standardized echocardiographic protocols are crucial for valid comparisons.
Objectives:
To determine normal values for variables of left ventricular diastolic function in children measured by Doppler echocardiography and their relations to body surface area (BSA).
Background:
There is increasing interest in echocardiographic assessment of left ventricular diastolic function in children but normal data for children are limited.
Methods:
Assessment of left ventricular diastolic function was performed in 130 normal participants (aged from 2.4 months to 19.6 years) from their transmitral flow patterns obtained by pulsed wave Doppler echocardiography.
Results:
Centile charts for commonly used left ventricular diastolic functional variables plotted against BSA are presented. Peak early diastolic filling velocity and atrial phase filling velocity integral were independent of BSA. Although most other filling indices showed strong relations with BSA, some had more curvilinear relations with BSA due to additional interactions with heart rate. The increase in left ventricular filling with growth is largely achieved by an increase in the early "passive" contribution to filling. The slower heart rates of older children are associated with lower atrial phase filling velocities but increased filling time, so the atrial contribution to filling remains relatively constant.
Conclusions:
Normal values of many left ventricular diastolic function variables change with growth in children and cannot be extrapolated from adult data. The data presented are suitable for use in size matched matched comparative studies of left ventricular function in children. Careful standardisation of echocardiographic protocols is necessary to ensure the validity of any comparisons.
