Key result
Children with moderate to large atrial septal defects had significantly increased age-specific RVOT diameter (z-score +2.2, 95% CI 2.0-2.4, P<0.001) and RVOT VTI compared to normal values.
Why the study?
How does right heart volume overload in children with moderate to large ASD affect RVOT diameter, VTI, and systolic excursion compared to normal values?
Observational (n=115)
How does right heart volume overload in children with moderate to large ASD affect RVOT diameter, VTI, and systolic excursion compared to normal values?
RVOT VTI and diameter are significantly increased in children with moderate to large ASD, serving as relevant predictors for identifying enlarged RVOT size and flow.
OBJECTIVE: Aim of the study was to determine the influence of right heart volume overload in children with atrial septal defect (ASD) on right ventricular outflow tract (RVOT) variables. METHODS: A prospective study was conducted in 115 children (age range: 2 days-18.1 years) with a moderate to large ASD. We determined effects of age, body length (BL), body weight (BW), and body surface area (BSA) on the variables RVOT diameter, RVOT velocity time integral (VTI), and RVOT systolic excursion (SE), and tested the predictive value of published normal values for age, BW, BL, and BSA in our ASD patients. RESULTS: In our pediatric ASD patients, the age-specific RVOT diameter (z-score: +2.2, 95% CI: 2.0-2.4, P < 0.001) was significantly increased compared to normal values with 54% of our ASD patients having a z-score >2.0. The age-specific RVOT VTI z-score (z-score: +3.6, 95% CI: 3.2-3.9, P < 0.001) was significantly increased compared to normal values with 81% of our ASD patients having a z-score >2.0. The age-specific RVOT SE z-score was not increased but slightly lower compared to normal values (z-score: -0.5, 95% CI: -0.7 to -0.3, P < 0.001) with 3% of our ASD patients having a z-score >2.0 while 12% of the patients had a z-score <-2. CONCLUSION: In our study population, we show the RVOT VTI and diameter to be relevant predictors in identifying an enlarged RVOT size and flow in children with moderate to large ASD.
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Köestenberger et al. (2016) conducted an observational in Atrial septal defect (n=115). Moderate to large atrial septal defect vs. Published normal values was evaluated on Age-specific RVOT diameter z-score (z-score +2.2, 95% CI 2.0-2.4, p=< 0.001). Children with moderate to large atrial septal defects had significantly increased age-specific RVOT diameter (z-score +2.2, 95% CI 2.0-2.4, P<0.001) and RVOT VTI compared to normal values.
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