Normal Values of Left Atrial Volume in Pediatric Age Group Using a Validated Allometric Model

Abstract

2, respectively, and was validated against an independent sample. The mean indexed LAV±SD for BSA≤1 m 2 and >1 m 2 is 31.5±5.5 mL and 26.0±4.2 mL, respectively, and was used to derive Z-scores. Conclusions-This

Left Atrial Volume Is Superior to the Ratio of the Left Atrium to Aorta Diameter for Assessment of the Severity of Patent Ductus Arteriosus in Extremely Low Birth Weight Infants

“…Recently, Bhatla et al reported that (1) LAV/BSA 1 depends on BSA; (2) LAV/BSA 1 reduces as BSA reduces; and (3) LAV/BSA 1 was approximately 10 ml/m 2 in patients with BSA=0.2 m 2 , which is significantly smaller than that in adults. 16 Similarly, Jantzen et al reported 11.7±4.2 ml/m 2 in normal neonates with a mean BSA of 0.19 m 2 . 14 Khositseth et al used the prolate ellipse method, in which 3-dimensional diameters are multiplied, to calculate LAV, and assessed the relationship between LAV/BSA 1 and PDA in preterm infants with gestational age <33 weeks.…”

“…In contrast, as shown in Figure 1D, LAV/BSA 1.54 (23.5±9.3 ml/m 3.08 ) did not depend on BSA (P=0.72). This model met all the following validation criteria: 16 (1) LAV/BSA 1.54 showed no significant residual relationship to BSA ( Figure 1D); (2) the intercept of LAV with BSA 1.54 for this group was not significantly different from zero (0.0028 ml, P=0.95); and (3) minimal heteroscedasticity was observed by visual inspection. Similarly, AE was 1.52 for LAV4CV.…”

“…The LAV was indexed using BSA to the power of the derived AE that was then regressed against BSA to assess for a residual relationship. 16 LVDd% of normal (LVDd%N) 24 was calculated in percent as estimated LVDd, where estimated LVDd (in mm)=0.495× BH (in cm)-5.43. 18 To seek an easier but accurate correction of LAV4CV, we performed linear regression between LAV4CV and BH, and obtained the estimated LAV4CV by BH.…”

“…15 However, no study of LAV has specifically targeted ELBWIs, in whom PDA is considerably more clinically important than in any other birth weight group. In addition, indexing chamber volumes using BSA to the exponent of 1 may be physiologically incorrect, 16 because an allometric model has been validated as the appropriate mathematical scaling for various cardiovascular structures to adjust for body size. 17 Allometric model analysis revealed that not LAV/BSA 1 but rather LAV/BSA 1.48 is an appropriate body size correction for LAV in children with BSA <1 m 2 .…”

“…17 Allometric model analysis revealed that not LAV/BSA 1 but rather LAV/BSA 1.48 is an appropriate body size correction for LAV in children with BSA <1 m 2 . 16 Optimal BSA correction of LAV in ELBWIs may be achieved with this model because of an approximate 2-fold difference of BSA in ELBWIs.…”