Estimation of Z-Scores of Cardiac Structures in Healthy Indian Pediatric Population

Introduction: Nomograms of pediatric cardiac structures are an effective tool to differentiate between normal and abnormal changes in dimensions of the heart. There is impending need for nomograms of Z -Scores of echocardiographic data derived from Indian children. Objective: The main objective of this study is to gather echocardiographic data from the healthy Indian pediatric population visiting the pediatric cardiology outpatient clinic and to derive the Z -Scores for various cardiac structures. Materials and Methods: All the echocardiographic studies from an eligible normal Indian population at a single centre were assessed. All the studies were performed on a single vendor echocardiography machine using weight appropriate neonatal, pediatric, and adult probes. Statistical Analysis: Body surface area (BSA) was used as an independent variable in a nonlinear regression analysis for the predicted mean value of each of the 19 echocardiographically measured structures. Results: The total number of children evaluated during the study period was 596, with age ranging from newborn to 16 years. The total parameters collected in the study were 8102. The correlation with Haycock's BSA and an individual parameter was found to be the most sensitive predictor of normal progression with age. Relationship of individual parameters with BSA was represented in the form of graphs. Conclusion: This study of normal Indian pediatric population is the largest Indian study to date. The regression formulae along with the graphs can be used to acquire the Z score of 19 individual echocardiographic parameters.