Left Heart Volume Estimation in Infancy and Childhood

Left ventricular (LV) volume determinations by the area-length method were reevaluated in postmortem studies of left ventricles ranging from 0.5 to 90 cm3 absolute volume. The regression equation relating known and calculated volumes for calculated volumes <15 cm3 (V′ = 0.733V) was found to be significantly different from that for calculated volumes >15 cm3 (V′ = 0.974V - 3.1). From these equations, normal values for cinecardiographic LV end-diastolic volume (LVEDV), LV ejection fraction (LVEF), LV systolic output (LVSO), LV mass (LVM), and left atrial maximal volume (LAMax) were derived from 56 children (19 < 2 years) with normal left ventricles who underwent cardiac catheterization. Values for LVEDV/BSA were significantly less for infants (< 2 years) than for older children (42 ± 10 versus 73 ± 11 cm3/m2, P <0.001). Values for LAMax/BSA were also less for infants than for older children (26 ± 5 versus 38 ± 8 cm3/ m2, P <0.001), and LVEF was significantly increasel for infants (0.68 ± 0.05 versus 0.63 ± 0.05, P <0.01). The values for LVM/BSA (88 ± 12 g/m2) and LVSO/BSA (4.42 ± 0.95 liters/min/m2) were not significantly different for infants and older children. Multiple regression equations were derived for the prediction of normal volume and mass variables from a patient's height, weight, and age. The predicted values can be obtained from nomograms, and estimations of normalcy can be made by comparisons of observed and predicted values with the 95% limits as defined.