Relationship of the dimension of cardiac structures to body size: an echocardiographic study in normal infants and children

Abstract

Normalization of the dimensions of cardiac structures to the size of the body, using so-called Z scores, is becoming increasingly common in the management of infants and children with congenital heart disease. Current published nomograms for the ascertainment of Z scores for cardiac structures in childhood are based largely on normal data obtained in formalin-fixed hearts. Since decisions concerning management are frequently based on the findings of cross-sectional echocardiograms, the dimensions of 15 cardiac structures were measured using cross-sectional echocardiography in 125 normal infants and children. Regression equations were derived relating cardiac dimensions to the size of the body. The expression of size with the highest correlation to cardiac dimensions was body surface area. Nomograms were then developed from which the Z score of a cardiac structure could be estimated from a knowledge of the body surface area and the echocardiographically derived measurement.

Guidelines and Standards for Performance of a Pediatric Echocardiogram: A Report from the Task Force of the Pediatric Council of the American Society of Echocardiography

“…The reader is referred to other resources for a more detailed discussion of the theoretic principles for these measurements and for the technical aspects of their performance. [43][44][45][46][47][48][49][50] The recommended measurements are grouped into measurements of cardiovascular structures, ventricular size and function measurements, hemodynamic measurements, and miscellaneous measurements.…”

“…Normative data for many cardiovascular structures exist, [44][45][46][47][48][49][50] and are generally adjusted to a calculation of body surface area using the height and weight of the patient. Valve and vascular diameters relate linearly to the square root of body surface area, whereas valve and vascular areas relate to body surface area.…”

“…In addition to reporting the absolute values, it is useful to report quantitative measures within the context of age-or size-appropriate norms (eg, z-score values). 61,62 Doppler information concerning the atrioventricular valves, semilunar valves, and any shunt sites should be provided. Quantitative Doppler information such as velocity data, patterns of spectral flow, and color jet dimensions, and semiquantitative estimates of insufficiency or stenosis, where appropriate, should be included in the report.…”

Chronic Left Ventricular Pacing Preserves Left Ventricular Function in Children

“…1) and averaged to minimize overor underestimation in case of an asymmetric mechanical activation pattern. To estimate the degree of LV dilation and to compare patients of different ages and weights, LVEDD was expressed as a z-score of normal [5].…”

Percutaneous Balloon Valvotomy in Pulmonary Atresia With Intact Ventricular Septum

“…The tricuspid valve Z score, RV length Z score, and RV area Z score were calculated according to published formulas. 8 The presence and degree of pulmonary insufficiency were determined from the initial echocardiographic study after dilation.…”