No abstract

No abstract

Subxiphoid echocardiographic bullet method of measuring LVEDV shows a good agreement with CMR obtained LV size in young children.

Right ventricular dysfunction is under-recognised in children presenting with idiopathic dilated cardiomyopathy. The need for clinical circulatory support and left ventricular ejection fraction z-score less than minus 8 were primary determinants of outcome, independent of the degree of derangement in right ventricular function.

Left ventricular vortex formation optimizes the effective transport of blood volume while minimizing energy loss (EL). Vector flow mapping (VFM) derived EL patterns have not been described in children < 1 year. A prospective cohort of 66 (0 days - 22 years, 14 patients ≤ 2 months) cardiovascularly normal children was used to determine LV vortex number, size (mm2), strength (m2/sec) and energy loss (mW/m/m2) in systole and diastole and compared across age groups. One early diastolic (ED) vortex at the anterior mitral leaflet & one late diastolic (LD) vortex at the LV outflow tract (LVOT) were seen in all newborns ≤ 2 months. At > 2 months, two ED vortices and one LD vortex were seen, with 95% of subjects > 2 years demonstrating this vortex pattern. Peak and average diastolic EL acutely increased in the same 2 months - 2 years period and then decreased within the adolescent and young adult age groups. Overall, these findings suggest that the growing heart undergoes a transition to adult vortex flow patterns over the first two years of life with a corresponding acute increase in diastolic EL. These findings offer an initial insight into the dynamic changes of LV flow patterns in pediatric patients and can serve to expand our understanding of cardiac efficiency and physiology in children.