What are the normal values for left heart volume estimation in infancy and childhood using the area-length method?
Left ventricular end-diastolic volume and left atrial maximal volume indexed to body surface area are significantly smaller in infants compared to older children, while ejection fraction is slightly higher.
Left ventricular (LV) volume determinations by the area-length method were reevaluated in postmortem studies of left ventricles ranging from 0.5 to 90 cm 3 absolute volume. The regression equation relating known and calculated volumes for calculated volumes 15 cm 3 (V' = 0.974V - 3.1). From these equations, normal values for cinecardiographic LV end-diastolic volume (LVEDV), LV ejection fraction (LVEF), LV systolic output (LVSO), LV mass (LVM), and left atrial maximal volume (LAMax) were derived from 56 children (19 < 2 years) with normal left ventricles who underwent cardiac catheterization. Values for LVEDV/BSA were significantly less for infants (< 2 years) than for older children (42 ± 10 versus 73 ± 11 cm 3 /m 2 , P <0.001). Values for LAMax/BSA were also less for infants than for older children (26 ± 5 versus 38 ± 8 cm 3 / m 2 , P <0.001), and LVEF was significantly increasel for infants (0.68 ± 0.05 versus 0.63 ± 0.05, P <0.01). The values for LVM/BSA (88 ± 12 g/m 2 ) and LVSO/BSA (4.42 ± 0.95 liters/min/m 2 ) were not significantly different for infants and older children. Multiple regression equations were derived for the prediction of normal volume and mass variables from a patient's height, weight, and age. The predicted values can be obtained from nomograms, and estimations of normalcy can be made by comparisons of observed and predicted values with the 95% limits as defined.
Graham et al. (Tue,) studied this question.
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