Nomograms for two-dimensional echocardiography derived valvular and arterial dimensions in Caucasian children

Cantinotti, Massimiliano; Giordano, Raffaele; Scalese, Marco; Murzi, Bruno; Assanta, Nadia; Spadoni, Isabella; Crocetti, Maura; Marotta, Marco; Molinaro, Sabrina; Kutty, Shelby; Iervasi, Giorgio

doi:10.1016/j.jjcc.2016.03.010

Cited by 46 publications

(49 citation statements)

References 23 publications

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“…In Cantinotti et al (3) 's nomograms, the mean Ao ann was 13.48 mm, SoV was 18.4 mm and Asc ao was 16.6 mm according to the BSA of 0.75 m 2 . These values were measured as 13 mm, 17.3 mm and 15.97 mm, respectively, in our study.…”

Section: Discussionmentioning

confidence: 94%

“…Cantinotti et al (3) have performed 2D echocardiography and annulus and vascular diameter measurements in their study conducted on 1151 healthy Caucasian Italian children with the mean age of 23 months and with BSA 0.54 m 2 . In our study, the mean age was 5.68 years and BSA was 0.75 m 2 (3) .…”

Section: Discussionmentioning

confidence: 99%

“…Patients' height and weight values were assessed and BSA (Body surface area) and Z-score values were calculated. BSA was calculated through the formula of 4x+7/90+x, and Z-score values were obtained according to the report of Cantinotti et al (3) Written informed consent for participation was obtained.…”

Section: Patientsmentioning

confidence: 99%

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The Aortic Annulus, Sinus of Valsalva, Ascending Aorta and Z-score Values in Healthy Children

Paytoncu¹

2019

ejcm

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Objectives:The aim of this study is to evaluate echocardiographically (and determine pathology if there is any) the diameters and Z-scores of aortic annulus, sinus of valsalva and ascending aorta in healthy children. Materials and Methods:This retrospective crosssectional study includes seventy patients with no important hemodynamically congenital heart disease. Forty-one of 0-18 (average 5.69) year old patients are boys (58.6%) and 29 are girls (41.4%). Patients' height and weight values were assessed. Body surface area and Z-score values were calculated. Aortic annulus, sinus of valsalva and ascending aorta were measured on the parasternal long axis view. The indexed values were obtained by dividing all measured parameters by body surface area.Results: Average indexed aortic annulus value is 22.77 mm/m 2 ; sinus of valsalva value is 30.51 mm/m 2 and ascending aortic value is 28.30 mm/m 2 in our study. Average aortic annulus value for nine patients whose Z-scores are >2 is 26.5 mm/m 2 ; sinus of valsalva value is 38.24 mm/m 2 and ascending aortic value is 34.94 mm/m 2 . Conclusion:In the present study, children aged between 0-18 years, mean aortic annulus, sinus of valsalva and ascending aorta, Z-scores and indexed values (aortic annulus/mm 2 , sinus of valsalva/m 2 , ascending aorta/m 2 ) were determined. In this study including few patients, aortic dilatations have been observed in the measurements of six of 67 patients (8.9%) who visited for the first time and 9 of 70 patients in total (12%). It is remarkable that nonsyndromic newborn and infant patients who are thought to be healthy have also various levels of aortic dilatations even before they were diagnosed with aortopathy.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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The Aortic Annulus, Sinus of Valsalva, Ascending Aorta and Z-score Values in Healthy Children

Paytoncu¹

2019

ejcm

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“…In the pediatric population, the most widespread z-score formulas are based on nomograms by Gautier et al, Pettersen et al, and Cantinotti et al [15][16][17]. The z-score formulas are complicated, but they can be calculated using on-line calculators.…”

Section: Introductionmentioning

confidence: 99%

New Screening Tool for Aortic Root Dilation in Children with Marfan Syndrome and Marfan-Like Disorders

et al. 2020

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One of the roles of a pediatric cardiologist who suspects or diagnoses a genetically determined connective tissue disease (e.g., Marfan, Ehlers-Danlos, and Loeys-Dietz syndromes) is to assess whether the aortic root is dilated. The aortic root diameter is affected by the patient's age, sex, and body surface area. Therefore, the aortic root diameter needs to be determined and expressed as a z-score. Calculation of the z-score is time-consuming and problematic if used infrequently. This study aimed to introduce a simple screening method for identifying aortic root dilation in children. The study population consisted of 190 children who were diagnosed with Marfan syndrome or Marfan-like disorders. The aortic root ratio (ARr) was formulated. The value of the ARr was compared in each patient with the results in z-scores, which were obtained using on-line calculators based on the most widespread nomograms. The optimal cut-off value of the ARr was ≥ 18.7. At this cutoff point, the sensitivity of the ARr ranged from 88.3% to 100% and the specificity ranged from 94% to 97.8%. All of the patients in whom the ARr failed to identify aortic root dilation were also divergently classified by different nomograms. At the ARr cut-off point of ≥ 18.0, a sensitivity of 100% was achieved for all nomograms with minimal reduction in specificity. The ARr allows for rapid and precise screening for aortic root dilation in children. Unlike classic analysis, the ARr does not require nomograms or on-line calculations. Abbreviations ARrAortic root ratio EDS Ehlers-Danlos syndrome MFS Marfan syndrome NPV Negative predictive value PPV Positive predictive value ROC curve Receiver operating characteristic curve

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“…However, specific data on cardiac valve dimensions in preterm neonates are scarce [4]. Reference values have been established in term neonates or mixed populations of term and preterm neonates, often as a subgroup within a population spanning a broader range of childhood years [6][7][8][9][10][11][12][13][14][15][16][17] (Table 1). No study specifically aimed at preterm neonates, except for Skelton et al [11] and Abushaban et al [18].…”

Section: Introductionmentioning

confidence: 99%

Cardiac Valve Annulus Diameters in Extremely Preterm Infants: A Cross-Sectional Echocardiographic Study

et al. 2018

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Background: With the increasing incidence of births of very preterm very-low-birth-weight infants, there is a demand for echocardiographic reference values of cardiac dimensions. Objectives: The aim of this study was to provide reference values of cardiac valve annulus diameters in a cohort of extremely preterm very-low-birth-weight neonates and to correlate these with patient characteristics. Methods: Valve diameters of 376 infants of < 32 weeks’ gestation and with a birth weight of ≤2,000 g were measured using 2-dimensional echocardiography. Correlations between valve diameters and patient characteristics (birth length/weight, body surface area, gestational age, and sex) were assessed. Birth weight was used to establish linear regression models. Inter- and intraobserver agreement was assessed through intraclass correlation coefficient (ICC) analysis. Results: Substantial variability was found (aortic valve mean [standard deviation; range]: 5.0 mm [0.6; 3.7–6.5]; pulmonic valve: 5.8 mm [0.8; 3.4–7.9]; mitral valve: 8.0 mm [1.0; 5.5–10.5]; tricuspid valve: 7.6 mm [1.2; 4.9–10.6]). There was a moderate correlation between birth weight and valve diameter (R² aortic valve: 0.36; pulmonic valve: 0.20; mitral valve: 0.24; tricuspid valve: 0.24). Adequate intraobserver (ICC range 0.74–0.91) and interobserver agreement (ICC range 0.77–0.89) was found. Conclusions: Our study provides ready-to-use reference values for cardiac valve annulus diameters for extremely preterm infants.

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Nomograms for two-dimensional echocardiography derived valvular and arterial dimensions in Caucasian children

Cited by 46 publications

References 23 publications

The Aortic Annulus, Sinus of Valsalva, Ascending Aorta and Z-score Values in Healthy Children

The Aortic Annulus, Sinus of Valsalva, Ascending Aorta and Z-score Values in Healthy Children

New Screening Tool for Aortic Root Dilation in Children with Marfan Syndrome and Marfan-Like Disorders

Cardiac Valve Annulus Diameters in Extremely Preterm Infants: A Cross-Sectional Echocardiographic Study

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