Cardiovascular magnetic resonance normal values in children for biventricular wall thickness and mass

Abstract

Background Pediatric patients are becoming increasingly referred for cardiovascular magnetic resonance (CMR). Measurement of ventricular wall thickness is typically part of the assessment and can be of diagnostic importance, e.g. in arterial hypertension. However, normal values for left ventricular (LV) and right ventricular (RV) wall thickness in pediatric patients are lacking. The aim of this study was to establish pediatric centile charts for segmental LV and RV myocardial thickness in a retrospective multicenter CMR study. Methods CMR was performed in 161 healthy children and adolescents with an age range between 6 and 18 years from two centers in the UK and Germany as well as from a previously published CMR project of the German Competence Network for Congenital Heart Defects. LV myocardial thickness of 16 segments was measured on the short axis stack using the American Heart Association segmentation model. In addition, the thickness of the RV inferior and anterior free wall as well as biventricular mass was measured. Results The mean age (standard deviation) of the subjects was 13.6 (2.9) years, 64 (39.7%) were female. Myocardial thickness of the basal septum (basal antero- and inferoseptal wall) was 5.2 (1.1) mm, and the basal lateral wall (basal antero- and inferolateral) measured 5.1 (1.2) mm. Mid-ventricular septum (antero- and inferoseptal wall) measured 5.5 (1.2) mm, and mid-ventricular lateral wall (antero- and inferolateral wall) was 4.7 (1.2) mm. Separate centile charts for boys and girls for all myocardial segments and myocardial mass were created because gender was significantly correlated with LV myocardial thickness (p < 0.001 at basal level, p = 0.001 at midventricular level and p = 0.005 at the apex) and biventricular mass (LV, p < 0.001; RV, p < 0.001). Conclusion We established CMR normal values of segmental myocardial thickness and biventricular mass in children and adolescents. Our data are of use for the detection of abnormal myocardial properties and can serve as a reference in future studies and clinical practice.

Right-left ventricular shape variations in tetralogy of Fallot: associations with pulmonary regurgitation

“…PR has been associated with decreasing contribution of longitudinal shortening to the RV ejection and increasing lateral pumping, which results in larger volume changes and septal motion towards the RV [ 51 ], as seen in our data (Additional file 2 ). RV shortening has also been associated with exercise capacity in adult rTOF [ 52 ]. Fernandes et al .…”

Extracellular volume-guided late gadolinium enhancement analysis for non-ischemic cardiomyopathy: The Women’s Interagency HIV Study

“…In our study, this contributed to the difference in scar detection rate or scar amount between the proposed method and the manual analysis. Utilization of the ECV map as a guide especially helps the analysts when quantifying the LGE scar with a relatively unknown distribution [ 6 , 7 , 12 – 16 ]. Third, the excellent reproducibility of ECV-guided LGE analysis is an advantage in the systematic detection of small changes in scar size for the monitoring and management of non-ischemic patients, as well as to determine the prognostic risk of patients more accurately.…”

“…Replacement fibrosis of left ventricular (LV) scar quantified by the amount of late gadolinium enhancement (LGE) has been shown to be a better predictor of the risk of incident adverse clinical events than the presence/absence of LGE alone in different cardiac diseases [ 1 – 4 ]. However, quantification of LGE scar is challenging when the scar distributions are diffuse and patchy, which is typical in non-ischemic cardiomyopathy such as myocarditis [ 5 – 7 ], cardiomyopathies [ 8 – 11 ], and in human immunodeficiency virus (HIV) cohorts [ 12 – 16 ]. As a result, the quantification of scar mass or even the identification of LGE can present a huge challenge in non-ischemic cases.…”

Isolated systolic hypertension is associated with increased left ventricular mass index and aortic stiffness in adolescents: a cardiac magnetic resonance study

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