Journal of the American Society of Echocardiography
Clinical Investigations in ChildrenNormalizing Echocardiographic Measurements in Children and NeonatesEchocardiographic Nomograms for Chamber Diameters and Areas in Caucasian Children
Section snippets
Inclusion Criteria
Healthy Caucasian children evaluated in the outpatient department of the Pediatric Cardiology Department for the screening of congenital heart disease at Fondazione G. Monasterio CNR–Regione Toscana of Massa eligible for inclusion into the study were prospectively enrolled.
The presence of innocent defects such as a patent ductus arteriosus with small or less left-to-right shunting seen in the first 3 days of life or a patent foramen ovale was considered to be normal.7, 9 Premature neonates were
Subjects
A total of 1,091 children (age range, 0 days to 17 years) were enrolled. The mean age of the study population was 53.3 months (median, 34.9 months; interquartile range, 2.2–95.1 months; range, 0–17 years). Body weight ranged from 1.3 to 88.0 kg (median, 13.7 kg; interquartile range, 4.9–28.0 kg) (Table 3). Height ranged from 41 to 181 cm (median, 93 cm; interquartile range, 57–127 cm). BSA calculated with the Haycock formula22 ranged from 0.12 to 1.8 m2 (median, 0.6 m2; interquartile range,
Discussion
The importance of accurate pediatric nomograms has recently been addressed by various authors,1, 2, 3, 4, 5, 6, 7, 8 with recommendations to use Z scores for quantification during the performance of pediatric echocardiography. Various numeric and methodologic limitations of actual pediatric nomograms have been underscored by multiple authors.1, 2, 3, 4, 5, 6, 7, 8
The nomograms we present offer the advantage of a rigorous statistical approach6 whose importance has been widely explained1, 2, 3, 4
Conclusions
The nomograms provided in the present report may be considered helpful tools for clinicians to perform quantitative measurements of cardiac chamber areas and diameters in children with various acquired and congenital heart defects.
In particular, this work substantially covers the gap of knowledge on chamber dimensions in children with the advantage of a rigorous statistical design.
Further studies, however, are required to reinforce these data, as well as to evaluate other parameters of clinical
References (47)
The why and how of Z scores
J Am Soc Echocardiogr
(2013)- et al.
Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council
J Am Soc Echocardiogr
(2010) - et al.
Nomograms for blood flow and tissue Doppler velocities to evaluate diastolic function in children: a critical review
J Am Soc Echocardiogr
(2013) - et al.
A review and critique of the statistical methods used to generate reference values in pediatric echocardiography
J Am Soc Echocardiogr
(2013) - et al.
Regression equations for calculation of z-scores of cardiac structures in a large cohort of healthy infants, children, and adolescents: an echocardiographic study
J Am Soc Echocardiogr
(2008) - et al.
Normal values for left ventricular volume in infants and young children by the echocardiographic subxiphoid five-sixth area by length (bullet) method
J Am Soc Echocardiogr
(2011) - et al.
Three-dimensional echocardiographic evaluation of right ventricular volume and function in pediatric patients: validation of the technique
J Am Soc Echocardiogr
(2007) - et al.
Accuracy and reproducibility of real-time three-dimensional echocardiography for assessment of right ventricular volumes and ejection fraction in children
J Am Soc Echocardiogr
(2008) - et al.
Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults
J Pediatr
(1978) - et al.
Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography
J Am Soc Echocardiogr
(2010)
Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology
J Am Soc Echocardiogr
Can simple echocardiographic measures reduce the number of cardiac magnetic resonance imaging studies to diagnose right ventricular enlargement in congenital heart disease?
J Am Soc Echocardiogr
Comparability of Z-score equations of cardiac structures in hypoplastic left heart complex
J Am Soc Echocardiogr
Accurate and reproducible measurement of left ventricular volume and ejection fraction by contrast echocardiography: a comparison with magnetic resonance imaging
J Am Coll Cardiol
Current pediatric nomograms are only one source of error for quantification in pediatric echocardiography: what to expect from future research
J Am Soc Echocardiogr
Targeted neonatal echocardiography in the neonatal intensive care unit: practice guidelines and recommendations for training. Writing Group of the American Society of Echocardiography (ASE) in collaboration with the European Association of Echocardiography (EAE) and the Association for European Pediatric Cardiologists (AEPC)
J Am Soc Echocardiogr
Complications in the transition from fetal to neonatal life
J Obstet Gynecol Neonatal Nurs
Normalization of echocardiographically derived paediatric cardiac dimensions to body surface area: time for a standardized approach
Eur J Echocardiogr
Limitations of current echocardiographic nomograms for left ventricular, valvular and arterial dimensions in children: a critical review
J Am Soc Echocardiogr
Theoretical and empirical derivation of cardiovascular allometric relationships in children
J Appl Physiol
Echocardiographic nomograms for ventricular, valvular and arterial dimensions in Caucasian children with a special focus on neonates, infants and toddlers
J Am Soc Echocardiogr
The accuracy of echocardiographic assessment of left ventricular size in children by the 5/6 area x length (bullet) method
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