Evaluation of left ventricular size and function by echocardiography. Results in normal children.

Abstract

SUMMARY Left ventricular (LV) size and function were studied by echocardiography in 145 normal children. The LV end-diastolic diameter (EDD) and its percentage change with systole (%ALVD) were measured and mean velocity of circumferential fiber shortening (Vcf) calculated. The LV pre-ejection period (PEP) and ejection time (LVET) were determined from recordings of aortic valve motion.The EDD increased by approximately threefold during childhood and was best correlated with the log of body weight (r = 0. the log of body surface area (r = 0.96). The mean %lALVD was 36 ± 4 (SD), and this index of LV function was independent of age and heart rate. Mean Vcf was higher, and the absolute values of PEP and LVET shorter, in younger children with a faster heart rate. The mean ratio of PEP/LVET was 0.31 ± 0.003, and was relatively independent of age (r = -0.41) and heart rate (r = 0.37). The %ZALVD and PEP/LVET appear to be particularly useful indices of LV function because they remain constant during the course of childhood.casionally a shallow left lateral decubitus position was required to record the ventricular septum clearly. Left ventricular dimensions were measured in the standard manner ( fig. 1). End-diastolic diameter (EDD) was measured at the start of the QRS complex. End-systolic diameter (ESD) was measured at the point in late systole where the septum and LV posterior wall were in closest apposition. These measurements were made with the transducer angled slightly inferiorly and laterally from the point of maximal excursion of the mitral valve in subjects over one year of age. In younger children, as previously noted by Sahn et al.,7 the mitral leaflets appear to extend farther toward the apex, and the LV diameter decreases rapidly as the transducer is directed below the mitral valve. Therefore, in infants under one year of age the LV dimensions were measured at the point of maximal excursion of the mitral valve, from a position from which both leaflets could be visualized. Recordings satisfactory for determination of LV dimensions were obtained in 143 of the 145 subjects (99%).Left ventricular systolic time intervals were determined from recordings of the aortic valve at 100 mm/sec paper speed ( fig. 2)

Subclinical late cardiac toxicity in childhood cancer survivors

“…29,[35][36][37][38][39] We used a 1-way analysis of variance (ANOVA) to compare treatment history, cardiac risk factors, and echocardiographic findings across the treatment groups. We conducted general linear model univariate analyses with highest school grade completed (a proxy for socioeconomic status, because household income data were incomplete) and years off therapy as covariates, and we used diagnostic group and sex as fixed factors to identify predictors of physical health, vitality, general health, and the modified NYHA score.…”

Left Atrial Size and Risk of Major Cardiovascular Events During Antihypertensive Treatment

“…14 Endocardial fractional shortening was calculated as the ratio (diastolicϪsystolic LV internal diameter)/diastolic LV internal diameter, the LV ejection fraction by the Teichholz method, as validated previously, and LV mass using an autopsy-validated formula. [15][16][17][18][19] LV geometry was assessed from LV mass/body surface area and relative wall thickness in combination. 20 LV hypertrophy was considered present when LV mass/body surface area exceeded 116 g/m 2 in men and 104 g/m 2 in women, respectively.…”

Impact of valvular regurgitation on left ventricular geometry and function in hypertensive patients with left ventricular hypertrophy: the LIFE study

“…22 Endocardial fractional shortening was calculated from LV internal dimension in diastole and systole. 23 Values o27%, representing the 2.5th percentile in normal subjects, 24 identified depressed LV systolic chamber function. In individuals with increased relative wall thickness 25 or LV dilatation, 26 endocardial shortening is not representative of that at the LV midwall where mean LV end-systolic wall stress is applied.…”