Curvas de percentis de valores normais de medidas ecocardiográficas em crianças eutróficas procedentes da região centro-sul do Estado de São Paulo

Abstract

Objective: To asses the values of echocardiographic measurements in normal children without cardiopathy and to build percentile curves, relating them to the body surface (BS, m 2 ). Methods:We analyzed M-mode echocardiographic measurements for children between one and 144 months of age. We assessed right ventricular diastolic diameter (RVDd, mm) and left ventricular diastolic diameter (LVDd, mm), LV systolic diameter (LVSd, mm), right ventricular outflow tract diameter (RVOT, mm), aortic diameter (AoD, mm) and left atrial diameter (LAD, mm); left ventricular ejection fraction (LVEF, %); percentage of variation of left ventricular diameter (∆LV, %); interventricular septum diastolic thickness (IVSDT, mm) and LV posterior wall diastolic thickness (PWDT, mm); left ventricular mass (LVM, g) and LV mass index (LVMI, g/m2). Results:At the end of the study, 595 children (326 male) were assessed. The values of echocardiographic measurements showed a good correlation with BS and allowed the constructing of percentile curves (3%, 25%, 50%, 75% and 97%). Statistically significant differences between the genders were evidenced for the following variables: LVSd, LVDd, RVOT, AoD, LVM and LVMI, and the highest values were observed in male children. Conclusion:The percentile curves of the values obtained can be used as a reference to assess children with suspicion of cardiopathy or to follow-up on those with diagnosed cardiopathy or under treatment with potentially cardiotoxic drugs.

Reference intervals for the echocardiographic measurements of the right heart in children and adolescents: a systematic review

“…In 24 studies, the reference population consisted of individuals that were referred for echocardiography to exclude cardiac disease [6,8,9,15-35]. Nine of the studies presented the reference data of volunteers [12,14,22,36-41].…”

“…Table 1 summarizes the sample characteristics of all 51 included studies [6,8,9,12-33,35-60]. As the right heart examination should include a measure of the right atrial (RA) and RV size and structure, RV systolic function and pulmonary artery (PA) pressures, [1] our findings are presented in Table 2 (published reference data for right heart size/volume), Table 3 (published reference data for right heart morphology), Tables 4, 5, and 6 (published reference data for RV- and valve function),and Table 7 (published reference data for right heart haemodynamics).…”

“…While performing this review, we recognized several limitations of available reference data in paediatric echocardiography, including a lack of technical standardization of measurements, inappropriate “normal” subjects and choice of population [6,8,9,15-35], small sample sizes [12,13,21,22,33,37,49,51],[56,60] and heterogeneous methods of reporting reference values. A valid meta-analysis could not be performed because of the variability in the populations studied, in the methodology for performing and normalizing measurements, and in ways to express normalized data.…”

“…Many of the previous studies had limited sample sizes, and were conducted predominantly in North American and European populations. Thus there is potential for interpretation errors when assessing African children, given that environmental, social, economic and other factors may influence the anthropometric standards of a population [9]. …”

Assessment of a single monomorphic ventricular ectopy from the right ventricular outflow tract in standard and high resolution electrocardiogram

“…This concerns especially muscle, where echocardiography ultrasonography investigation is without any pathology. However, some patients have minimal changes regarding the structure of the heart based on advanced tests such as NMR, SPECT, PET [10, 11]. …”