This study establishes normal echocardiographic reference values for left ventricular dimensions and function in infants and children based on body surface area.
Supports BSA-adjusted LV dimension references in children; leaves open prospective validation before changing echo standards.
Echocardiographic studies were performed on 110 normal infants and children ranging in age from 2 days to 15 years. The following parameters of the left ventricle were measured: left ventricular end-diastolic and end-systolic diameters (LVEDd and LVESd), shortening fraction (LVSF), end-diastolic volume (LVEDV), ejection fraction (LVEF), posterior wall thickness in end-diastole (LVPWED) and end-systole (LVPWES), mass (LVM), LVEDd/LVPWED, LVESd/LVPWES and mean velocity of circumferential fiber shortening (LV mean Vcf). Each parameter was compared with body surface area (BSA). LVEDd, LVESd, LVEDV, LVPWED, LVPWES and LVM were expressed as a function of body surface area with exponential equations: LVEDd = 41.4 (BSA)0.49 mm, LVESd = 28.1 (BSA)0.49 mm, LVEDV = 74.1 (BSA)1.48 ml, LVPWED = 4.4 (BSA)0.45 mm, LVPWES = 9.2 (BSA)0.44 mm and LVM = 46.4 (BSA)1.48 g. LVSF, LVEDd/LVPWED, LVESd/LVPWES and LV mean Vcf were independent of body surface area: LVSF averaged 32 +/- 1 (mean +/- standard error of the mean)%, LVEF 68 +/- 1%, LVEDd/LVPWED 10.0 +/- 0.2, LVESd/LVPWES 3.1 +/- 0.1 and LV mean Vcf 1.08 +/- 0.02 circ/sec. Thus, normal values of these parameters can be applied to estimate them in pediatric patients with heart diseases.
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Akiba et al. (1986) studied this question.
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