Normal right and left ventricular volumes prospectively obtained from cardiovascular magnetic resonance in awake, healthy, 0- 12 year old children

Abstract

Introduction: Pediatric z scores are necessary to describe size and structure of the heart in growing children, however, development of an accurate z score calculator requires robust normal datasets, which are difficult to obtain with cardiovascular magnetic resonance (CMR) in children. Motion-corrected (MOCO) cines from re-binned, reconstructed realtime cine offer a free-breathing, rapid acquisition resulting in cines with high spatial and temporal resolution. In combination with child-friendly positioning and entertainment, MOCO cine technique allows for rapid cine volumetry in patients of all ages without sedation. Thus, our aim was to prospectively enroll normal infants and children birth-12 years for creation and validation of a z score calculator describing normal right ventricular (RV) and left ventricular (LV) size. Methods: With IRB approval and consent/assent, 149 normal children successfully underwent a brief noncontrast CMR on a 1.5 T scanner including MOCO cines in the short axis, and RV and LV volumes were measured. 20% of scans were remeasured for interobserver variability analyses. A general linear modeling (GLM) framework was employed to identify and properly represent the relationship between CMR-based assessments and anthropometric data. Scatter plots of model fit and Akaike's information criteria (AIC) results were used to guide the choice among alternative models. Results: A total of 149 subjects aged 22 days-12 years (average 5.1 ± 3.6 years), with body surface area (BSA) range 0.21-1.63 m 2 (average 0.8 ± 0.35 m 2) were scanned. All ICC values were > 95%, reflecting excellent agreement between raters. The model that provided the best fit of volume measure to the data included BSA with higher order effects and gender as independent variables. Compared with earlier z score models, there is important additional growth inflection in early toddlerhood with similar z score prediction in later childhood. Conclusions: Free-breathing, MOCO cines allow for accurate, reliable RV and LV volumetry in a wide range of infants and children while awake. Equations predicting fit between LV and RV normal values and BSA are reported herein for purposes of creating z scores. Trial registration: clinicaltrials.gov NCT02892136, Registered 7/21/2016.

Normative ranges of biventricular volumes and function in healthy term newborns

“…However, the cohort grouped children between 0 and 6 years of age (n = 12), likely accounting for the difference. Similarly, a recent large prospective pediatric study was conducted by Olivieri et al to assess ventricular volumes and mass in healthy children and infants [ 11 ]. The study enrolled infants ranging from 21 days to 9 months (n = 23) which reflects a different age group when compared to our study.…”

Reference data for left ventricular filling and atrial function in children using cardiovascular magnetic resonance

“…Further investigation with a prospective cohort may improve LA volume analysis. Our study was also limited by sample size, though the total sample is similar to prior pediatric reports [ 17 , 18 , 31 ]. In particular, there was a small sample of children less than 10 years old and none below 7 years old, which is not an uncommon limitation in pediatric CMR studies.…”

Right ventricular afterload in repaired D-TGA is associated with inefficient flow patterns, rather than stenosis alone

“…All images were performed on a 1.5 T MR scanner (Aera; Siemens Healthcare, Erlangen, Germany) with an 18-channel body matrix array anteriorly. All sequence parameters, including repetition time (TR), echo time (TE), field-ofview (FOV), and voxel size, were performed in accordance with laboratory standards for cine, angiography, and flow sequences [20,21]. Standard volumetry and right ventricular mass measurements were performed using MedisSuite (Medis, Leiden, Netherlands), with mass calculated as the volume of tissue between the epicardial and endocardial borders indexed to body surface area.…”