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Role of left ventricular mass/volume ratio on transmitral flow velocity patterns from infancy to childhood
K Harada1, T Suzuki, K Shimada
1Department of Pediatrics, Akita University School of Medicine, Hondo, Japan.
Insights
This study reveals age-related changes in pediatric left ventricular diastolic filling, linking reduced early filling patterns to the mass/volume ratio in children. These findings highlight key developmental shifts in cardiac function.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Physiology
- Echocardiography
Background:
- Age-related alterations in left ventricular diastolic filling are observed in children using Doppler echocardiography.
- Limited data exists on the relationship between transmitral flow velocity patterns and left ventricular mass in pediatric populations.
Purpose of the Study:
- To investigate the relationship between left ventricular mass and transmitral flow velocity patterns in normal children.
- To characterize age-related changes in left ventricular diastolic filling and its correlation with cardiac morphology.
Main Methods:
- M-mode and Doppler echocardiography were used to assess 165 normal children (5 days to 195 months).
- Measurements included left ventricular end-diastolic volume, mass, mass/volume ratio, and transmitral flow velocity patterns.
- Subjects were stratified into six age groups to analyze developmental trends.
Main Results:
- Left ventricular end-diastolic volume and mass increased with age.
- The mass/volume ratio was significantly higher in infants <1 year compared to those 1 to <3 years.
- Peak E wave velocity and early diastolic filling fraction decreased with age, while the E/A wave ratio increased.
- The mass/volume ratio correlated with peak E wave velocity and early diastolic filling fraction.
Conclusions:
- Age-related reductions in the mass/volume ratio may contribute to altered early diastolic ventricular filling in children.
- Doppler echocardiographic parameters of diastolic function show significant age-dependent changes in pediatric populations.
- The study provides insights into normal cardiac development and diastolic function assessment in children.
Abstract:
Age-related changes in left ventricular diastolic filling have been reported to occur in normal children in studies using Doppler echocardiographic methods. However, little information currently exists on the relationships between transmitral flow velocity patterns and the left ventricular mass. We measured left ventricular end-diastolic volume, left ventricular mass, mass/volume ratio, and transmitral flow velocity patterns by M-mode and Doppler echocardiography in 165 normal children aged 5 days to 195 months. Subjects were divided into 6 age groups: <1; 1 to <3; 3 to <5; 5 to <7; 7 to <9; and > or = 9 years old. The left ventricular end-diastolic volume and mass increased progressively with increasing age. However, the mass/volume ratio in infants <1 year was significantly higher than that in infants 1 to <3 years (1.32+/-0.25 vs. 1.14+/-0.16, p<0.01) without any changes of the ratio thereafter. The peak E wave in infants <1 year was significantly lower than that in 1 to <3 years (71+/-18 vs. 92+/-13 cm/s, p<0.01) without changes thereafter. As the flow velocity time integral of E wave increased and that of A wave remained constant, the flow velocity time integral of E/A wave increased with increasing age. The early diastolic tilling fraction in infants <1 year was lower than that in infants 1 to 3 years. (0.61+/-0.07 vs. 0.70+/-0.06, p<0.01). The atrial filling fraction in infants <1 year was higher than that in infants 1 to <3 years (0.40+/-0.08 vs. 0.30+/-0.06, p<0.01) with a little decrease thereafter. The peak E wave, early diastolic tilling fraction, and the atrial filling fraction correlated with the logarithm of age (p<0.01). Age-related changes in these Doppler echocardiographic findings suggest reduced left ventricular early diastolic filling patterns. The mass/volume ratio correlated linearly with peak E wave, early diastolic filling fraction, and atrial filling fraction (r=-0.38, -0.33, and 0.26, p<0.01). No significant relationships between mass/volume ratio and the other Doppler indices were found. Thus, the age-related reduction in the mass/volume ratio may be one of the mechanisms underlying age-related changes in the early diastolic ventricular filling as assessed by Doppler echocardiography.