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, discussing leaflets and sinuses as separate components of the root instead of interchangeably referring to both as ''cusps''), including recognizing the deficiencies in commonly used classifications for the congenitally malformed aortic valve. This deficiency includes the often underrecognized unicuspid and unicommissural aortic valve, 2 which was not assessed, or possibly not appreciated, in the given account. Although objective data to support the best methods for 2D assessment and continued monitoring of asymmetric aortic roots in congenitally malformed aortic valves are currently absent, we should nonetheless aim our sights higher. It is now commonplace to view cardiac anatomy in three dimensions using multiple imaging modalities. Ideally, the imager could reliably follow aortic root volumes for a more accurate assessment, especially given that the aortic root dilates not just circumferentially but also longitudinally. 2 In the meantime, would not MRI or computed tomographic 2D areas prove more accurate? Such normative data in adults as assessed by MRI have already been supplied. 4 Could biplane TTE provide similar accuracy in measuring short-axis areas? The work is clearly laid out for improved understanding in assessment of aortic root dimensions, and we are thankful to Vis et al. 1 for pushing forward this topic, which holds clear clinical significance.

BackgroundLeft ventricular (LV) volumes are basic parameters used to estimate ventricular size and function; however, normal values are not available in children. The aim of our study is to provide normal values for LV volumes (measured with the biplane Simpson method) in healthy children.Materials and methodsWe prospectively studied 1320 healthy Caucasian Italian children (age 0 days‐17 years, 49.4% female). Echocardiographic measurements on LV volumes were performed. Age, heart rate (HR), and body surface area (BSA) were used as independent variables in different analyses to predict the mean values of each measurement.ResultsModels with exponential (ln[y] = a + b*ln[x]) equations resulted in the best fit for LV volumes. The association with BSA was found to be stronger than the association of HR and age. Thus BSA was used for normalization of our data. Predicted values and Z‐score boundaries by BSA are provided.ConclusionsWe report normal values for 2D biplane LV volumes in a population of healthy children. These data cover a gap in current pediatric echocardiographic nomograms and may serve as baseline for evaluation of children with cardiac defects characterized by LV dilatation or hypoplasia.