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Estimation of z-scores of cardiac structures in healthy children in Southeast Nigeria

  • Original Article
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Abstract

Background

The z-scoring system shows the mean deviation of cardiac dimensions from age-specific population. The use of the European-based z-score studies has resulted in misdiagnosis and late treatment of Nigerian children with heart diseases leading to increased mortality and morbidity.

Objectives

This study aimed to determine the z‑scores for various cardiac structures and functions among healthy children in Southeast Nigeria.

Materials and methods

This is a cross-sectional observational study where z-scores of the cardiac structure and function of three hundred healthy children were estimated using echocardiography and compared with the standard Detroit values.

Result

There was a significant positive correlation between age and cardiac valve diameter. The aortic valve strongly correlated positively with age with the Pearson correlation coefficient (ρ) of 0.8 and probability value (P-value) of 0.00. None of the ventricular function variables deviated beyond the +2 or −2 z-score. There was a positive correlation between the z-scores of ventricular function parameters and participants’ age, although the strength of the correlation varied. Comparing these values with that of Detroit values, there was a significant difference in the deviation of the mean of the mitral valve and left pulmonary artery diameters from the Detroit values between the males and the females. While the mean z-score mitral valve was 0.8 in males, it was 0.6 in females (P = 0.02).

Conclusion

Z-scores of cardiac structures and function are derived from children in this locale. These values were similar to that of Detroit values except for the mitral valve and left pulmonary artery.

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Data availability

Data are however available from the authors upon reasonable request and with permission of the corresponding author.

Abbreviations

IVSd :

inter ventricular septum diameter in diastole

LVIDd :

left ventricular internal diameter in diastole

LVPWd :

left ventricular posterior wall diameter in diastole

IVSs :

inter ventricular septum diameter in systole

LVIDs :

left ventricular internal diameter in systole

EF :

ejection fraction

FS :

fractionating shortening

LV mass :

left ventricular mass

MV :

mitral valve annular diameter

PV :

pulmonary valve annular diameter

AV :

aortic valve annular diameter

TV :

tricuspid valve annular diameter

RPA :

right pulmonary artery

LPA :

left pulmonary artery

MPA :

main pulmonary artery

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Acknowledgements

We acknowledge the typist and echo lab nurse for helping in the recording of the values obtained in this study.

Author information

Authors and Affiliations

  1. Department of Paediatrics, College of Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria

    Josephat M Chinawa & Bartholomew Chukwu

  2. Department of Community Medicine, ESUCOM, Parklane, Enugu, Nigeria

    Awoere Chinawa

Authors
  1. Josephat M Chinawa
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  2. Bartholomew Chukwu
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  3. Awoere Chinawa
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Contributions

CJM conceived and designed this study while CJM, OEN, CAT helped in the critical revision of the article. All authors have read and approved the manuscript.

Corresponding author

Correspondence to Josephat M Chinawa.

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Ethics approval

Ethical clearance was obtained from the research and ethic committee of the University of Nigeria, Ituku-Ozalla. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standard. Ethical clearance for the study was obtained from the Research and Ethical Committee of the University of Nigeria Teaching Hospital Ituku-Ozalla.

Consent to participate

Informed consent was sought from parents or caregivers of potential subjects before enrolling them in the study while assent was obtained from children who are 7 years old and above.

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The authors declare no competing interests.

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Chinawa, J., Chukwu, B. & Chinawa, A. Estimation of z-scores of cardiac structures in healthy children in Southeast Nigeria. Ir J Med Sci 193, 689–698 (2024). https://doi.org/10.1007/s11845-023-03542-z

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