A simple method for assessing the regression or progression of ventricular hypertrophy in the growing child and adult: the value of left ventricular wall-to-cavity ratios.

Abstract

To establish the normal range of diastolic and systolic left ventricular wall-to-cavity ratios. Two hundred and sixty-two normal subjects (age 0-40 years), 15 children with valvar aortic stenosis and 11 childhood athletes were studied with M-mode echocardiography. Values of diastolic septum-to-cavity ratio and diastolic left ventricular wall-to-cavity ratio were not influenced by sex nor, in adults, by height, weight or body surface area. There were slight age variations from 0-15 years of age, but not in adults from 15-40 years of age. Values of diastolic left ventricular wall-to-cavity ratio in neonates were 0.18 (95% confidence limits 0.17-0.19); in 3-5 year olds 0.16 (0.15-0.16); and in adults 0.18 (0.17-0.19). In valvar aortic stenosis there is a positive correlation between the Doppler-estimated pressure gradient and the degree of left ventricular hypertrophy, as expressed by both diastolic and systolic left ventricular wall-to-cavity ratio (r = 0.90;P < 0.00001 and r = 0.85;P = 0.00006 respectively). Diastolic septum and left ventricular wall-to-cavity ratios accurately differentiate physiological from pathological left ventricular hypertrophy in the growing child. Because these ratios are independent of sex and body size, they may also be more sensitive than absolute wall thickness in the detection of abnormal left ventricular hypertrophy in adults.