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Left ventricular myocardial mass determined by cross-sectional echocardiography in normal newborns, infants, and children

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Summary

Changes in left ventricular muscle mass may be an important diagnostic or prognostic finding in children with congenital heart defects, but there are no data on normal mass as determined by cross-sectional echocardiography (CSE) in children. Fourteen newborns, 12 infants, and 69 children (1.5–17 years old) with a structurally normal heart were studied. Enddiastolic and end-systolic volume and mass were calculated from biplane-paired echocardiographic imaging planes—apical two-chamber and apical four-chamber views—using both an area/length and a Simpson's rule geometric method. Data were compared with M-mode measurements. There was a good correlation between area/length and Simpson's rule method [r=0.94, standard error (SE) 4 g/m2].

To validate the measurements, interobserver data were gathered and end-diastolic and endsystolic mass measurements were compared. Interobserver variability for the measurements on the echocardiographic recordings was low at 4.8%; for end-diastolic mass the correlation between two observers wasr=0.99 (SE 3.3 g/m2) and for end-systolic massr=0.97 (SE 7.6 g/m2). Correlation between end-systolic and end-diastolic mass was acceptable (r=0.88, SE 5.9 g/m2) for the CSE mass determination, but poor for the M-mode measurements (r=0.51, SE 20.2 g/m2). Similarly, correlation between M-mode mass and mass estimated by CSE was poor, atr=0.58 for end-diastolic andr=0.094 for end-systolic mass. In newborns and infants the ratio of end-diastolic mass to end-diastolic volume was higher than in the older children, mainly because of a smaller ventricular volume in relation to body surface area in this age group.

In the 26 newborns and infants, left ventricular mass was 48.7±10 g/m2 and volume was 34.6±7 ml/m2, yielding a mas to volume ratio of 1.41±0.03. For the 69 children (mean age 7.4±3.8 years), left ventricular mass was 63±10 g/m2 and volume 59±10 ml/m2 with a mass to volume ratio of 1.07±0.2. Left ventricular end-diastolic mass and volume strongly correlated with age (r=0.9) and body surface area (r=0.98 and 0.97, respectively). As CSE is easy to perform and repeatable, these normal values should provide a valuable database for further longitudinal studies of the development of left ventricular mass in patients with various cardiac abnormalities.

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  1. Department of Pediatrics, Deutsches Herzzentrum, Munich, Federal Republic of Germany

    Michael Vogel, Werner Staller & Konrad Bühlmeyer

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  1. Michael Vogel
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  2. Werner Staller
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  3. Konrad Bühlmeyer
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Vogel, M., Staller, W. & Bühlmeyer, K. Left ventricular myocardial mass determined by cross-sectional echocardiography in normal newborns, infants, and children. Pediatr Cardiol 12, 143–149 (1991). https://doi.org/10.1007/BF02238520

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