Sunil J Ghelani1, David W Brown2, Joseph D Kuebler2, Douglas Perrin3, Divya Shakti2, David N Williams4, Gerald R Marx2, Steven D Colan2, Tal Geva2, David M Harrild2. 1. Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. Electronic address: sunil.ghelani@cardio.chboston.org. 2. Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. 3. Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts. 4. Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.
Abstract
BACKGROUND: Assessment of left atrial (LA) size and function is important in a number of pediatric cardiac conditions including those affecting the diastolic performance of the left ventricle. Measurements of LA volume and strain by two-dimensional echocardiography rely upon inaccurate geometric assumptions and are hampered by out-of-plane motion. The objective of this study was to characterize LA volumes and strain by three-dimensional echocardiography in healthy children. METHODS: LA volumes and strain were retrospectively measured by three-dimensional echocardiography in healthy children with no known structural or functional heart disease using a commercial speckle-tracking package applied to the LA to compute maximum volume (Vmax), minimum volume (Vmin), ejection volume (LAEV), ejection fraction (LAEF), and the following components of global strain: 3D principal (3DS), longitudinal (GLS), and circumferential (GCS). RESULTS: The study population included 196 normal subjects (median age, 12 years; range, 4 days to 20.9 years). Vmax, Vmin, and LAEV increased with age and body surface area. Significant age-related declines were present in all measured functional indices including LAEF, 3DS, GLS, and GCS. Analysis of a subset of 50 subjects showed excellent agreement between Vmax derived by three-dimensional and two-dimensional biplane area-length method. Regression equations with standard deviations were generated to enable calculation of Z scores. CONCLUSIONS: LA volume and functional indices can be reliably calculated using a commercial three-dimensional analysis software. All components of LA strain decline modestly with age. Normative data generated in this study have the potential to greatly enhance the utility of three-dimensional echocardiography-derived measurements in a wide range of cardiac pathologies.
BACKGROUND: Assessment of left atrial (LA) size and function is important in a number of pediatric cardiac conditions including those affecting the diastolic performance of the left ventricle. Measurements of LA volume and strain by two-dimensional echocardiography rely upon inaccurate geometric assumptions and are hampered by out-of-plane motion. The objective of this study was to characterize LA volumes and strain by three-dimensional echocardiography in healthy children. METHODS: LA volumes and strain were retrospectively measured by three-dimensional echocardiography in healthy children with no known structural or functional heart disease using a commercial speckle-tracking package applied to the LA to compute maximum volume (Vmax), minimum volume (Vmin), ejection volume (LAEV), ejection fraction (LAEF), and the following components of global strain: 3D principal (3DS), longitudinal (GLS), and circumferential (GCS). RESULTS: The study population included 196 normal subjects (median age, 12 years; range, 4 days to 20.9 years). Vmax, Vmin, and LAEV increased with age and body surface area. Significant age-related declines were present in all measured functional indices including LAEF, 3DS, GLS, and GCS. Analysis of a subset of 50 subjects showed excellent agreement between Vmax derived by three-dimensional and two-dimensional biplane area-length method. Regression equations with standard deviations were generated to enable calculation of Z scores. CONCLUSIONS: LA volume and functional indices can be reliably calculated using a commercial three-dimensional analysis software. All components of LA strain decline modestly with age. Normative data generated in this study have the potential to greatly enhance the utility of three-dimensional echocardiography-derived measurements in a wide range of cardiac pathologies.
Authors: Cristhian H Aristizábal-Duque; Juan Fernández Cabeza; Isabel María Blancas Sánchez; Mónica Delgado Ortega; Pilar Aparicio Martinez; Manuel Romero-Saldaña; Francisco Javier Fonseca Del Pozo; Manuel Pan; Martin Ruiz Ortiz; María Dolores Mesa-Rubio Journal: J Clin Med Date: 2022-06-08 Impact factor: 4.964