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Cardiac function in healthy infants and children: Doppler echocardiographic evaluation
K Hanseus1, G Björkhem, N R Lundström
1Department of Pediatrics, University Hospital, Lund, Sweden.
Insights
This study establishes normal Doppler-derived cardiac function values for infants and children, finding heart rate influences stroke distance and ejection time in older children. These findings aid in accurate pediatric cardiac assessment.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Hemodynamics
Background:
- Accurate assessment of cardiac function in children is crucial for diagnosing and managing various cardiovascular conditions.
- Doppler echocardiography provides non-invasive measurements of cardiac performance.
- Establishing age-specific normal values for Doppler-derived parameters is essential for reliable interpretation.
Purpose of the Study:
- To determine normal values for Doppler-derived cardiac function parameters in healthy infants and children.
- To analyze the relationship between these parameters and factors like heart rate, age, and body surface area.
- To assess the reproducibility of Doppler measurements in this pediatric population.
Main Methods:
- Pulsed-wave Doppler recordings of the ascending aorta were acquired in 80 healthy children.
- Measurements included stroke distance, minute distance, peak velocity, mean acceleration, acceleration time, ejection time, and acceleration/ejection time ratios.
- Data were analyzed separately for children below and above 6 months of age, with correlation and reproducibility studies performed.
Main Results:
- Normal values (median and range, mean and standard deviation) were established for two age groups.
- Strong negative correlations between heart rate and stroke distance/ejection time were observed in older children.
- Good reproducibility was noted for stroke distance, minute distance, peak velocity, and left ventricular ejection time; acceleration-related measurements showed lower reproducibility.
Conclusions:
- This study provides essential reference ranges for Doppler-derived cardiac function in pediatric populations.
- Heart rate is a significant factor influencing specific Doppler parameters in older children and requires consideration during interpretation.
- While key parameters demonstrate good reproducibility, acceleration-related measurements warrant careful evaluation due to variability.
Abstract:
To establish normal values for Doppler-derived parameters of cardiac function, pulsed-wave Doppler recordings from the ascending aorta were obtained in 80 healthy infants and children. Stroke and minute distance, peak velocity, mean acceleration, acceleration and ejection time intervals, and the acceleration/ejection time ratios were measured or calculated from the Doppler recordings. The relations between the Doppler parameters and heart rate, age, and body surface area were analyzed separately for the children below and above 6 months of age. The normal values for the two groups are given as the median and range and as the mean and standard deviations, respectively. For the older age group, strong negative correlations with heart rate were found for stroke distance and ejection time, suggesting that these parameters should be evaluated in relation to heart rate. Intraobserver and interobserver reproducibility were studied in 10 children. Good reproducibility was found for stroke and minute distance, peak velocity, and left ventricular ejection time. For measurements related to acceleration, the reproducibility was less good.