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Reference intervals and percentile curve for left ventricular outflow tract ( LVOT ), velocity time integral ( VTI ), and LVOT ‐ VTI ‐derived hemodynamic parameters in healthy children and adolescents: Analysis of echocardiographic methods association and agreement
Author(s) -
Díaz Alejandro,
Zócalo Yanina,
CabreraFischer Edmundo,
Bia Daniel
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14176
Subject(s) - ventricular outflow tract , stroke volume , percentile , medicine , cardiology , hemodynamics , mathematics , heart rate , statistics , blood pressure
Background Echocardiographic reference intervals ( RI s) for left ventricular outflow tract ( LVOT ) and velocity time integral ( VTI ) are scarce in pediatrics. Aims (a) to generate RI s and percentiles for LVOT , VTI , and hemodynamic variables in healthy children and adolescents from Argentina; (b) to analyze the equivalence between stroke volume ( SV ), cardiac output ( CO ), and cardiac index ( CI ) obtained from two‐dimensional echocardiography (2D) and LVOT ‐ VTI analysis with pulsed wave Doppler ( PWD ); and (c) to analyze the association between subjects’ characteristics and VTI and LVOT ‐ VTI ‐derived parameters. Methods Two‐dimensional and PWD studies were done in 385 subjects (5–24 years). Mean and standard deviation age‐related and body surface area ( BSA )‐related equations were obtained for VTI and LVOT ‐ VTI ‐derived parameters (parametric regression methods based on fractional polynomials). BSA ‐ and age‐specific percentiles were determined. Results Pulsed wave Doppler‐ and 2D‐derived parameters were positively correlated. However, PWD values were always lower than those from 2D. Specific RI s for PWD and 2D data were necessary. Covariance analysis showed that sex‐specific RI s were required for LVOT , but not for VTI , VTI ‐derived CO and CI . Age‐related RI s were obtained for LVOT , LVOT ‐ VTI , and VTI ‐derived CO and CI . BSA ‐related RI s for VTI ‐derived CO and CI were obtained. Conclusions Stroke volume, CO , and CI data from 2D and PWD are not equivalent. An accurate analysis of LVOT ‐ VTI ‐derived parameters requires considering age and BSA . In this study, age‐ and BSA ‐related RI s and percentiles for LVOT , VTI , and hemodynamic parameters in healthy children and adolescents were determined, discriminating data according to the methodological approach (2D or PWD ).