Determinants and Regression Equations for the Calculation of z Scores of Left Ventricular Tissue Doppler Longitudinal Indexes in a Healthy Italian Pediatric Population.

Veronica Fibbi,Silvia Favilli,Enrico Chiappa,Iva Pollini,Gaia Spaziani,Alfredo Zuppiroli,Giovanni B Calabri,Piercarlo Ballo

doi:10.1155/2015/380729

Veronica Fibbi, Silvia Favilli + Show 6 more

Open Access

https://doi.org/10.1155/2015/380729

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Abstract

Aim. We investigated the predictors of tissue Doppler left ventricular (LV) longitudinal indexes in a healthy Italian pediatric population and established normative data and regression equations for the calculation of z scores. Methods and Results. A total of 369 healthy subjects aged 1–17 years (age of 6.4 ± 1.1 years, 49.1% female) underwent echocardiography. LV peak longitudinal velocity at systole (s '), early diastole (e '), and late diastole (a ') was determined by tissue Doppler. The ratio of peak early diastolic LV filling velocity to e ' was calculated. Age was the only independent determinant of s ' (β = 0.491, p < 0.0001) and the strongest determinant of e ' (β = 0.334, p < 0.0001) and E/e ' (β = −0.369, p < 0.0001). Heart rate was the main determinant of a ' (β = 0.265, p < 0.0001). Male gender showed no effects except for a weak association with lateral s ', suggesting no need of gender-specific reference ranges. Age-specific reference ranges, regression equations, and scatterplots for the calculation of z scores were determined for each index. Conclusion. In a pediatric Italian population, age was the strongest determinant of LV longitudinal dynamics. The availability of age-specific normality data for the calculation of z scores may allow for correctly detecting LV dysfunction in pediatric pathological populations.

Highlights

Tissue Doppler (TD) imaging is an established echocardiographic technique that provides reproducible, sensitive, and easy-to-calculate indexes of longitudinal left ventricular (LV) function [1, 2]
Though the majority of TD studies have been performed in adults, TD has been widely used in pediatric populations as a tool to detect early LV longitudinal dysfunction in several pathophysiological conditions, in most cases by comparing patients with matched controls [3,4,5,6,7]
The aim of this study was to explore the determinants of LV longitudinal indexes in a healthy Italian pediatric population and to provide normative data obtained in a healthy Italian pediatric population

Summary

Introduction

Tissue Doppler (TD) imaging is an established echocardiographic technique that provides reproducible, sensitive, and easy-to-calculate indexes of longitudinal left ventricular (LV) function [1, 2]. Though the majority of TD studies have been performed in adults, TD has been widely used in pediatric populations as a tool to detect early LV longitudinal dysfunction in several pathophysiological conditions, in most cases by comparing patients with matched controls [3,4,5,6,7]. Obtaining normative data for LV longitudinal velocities, referred to as the possibility of allowing calculation of z scores, may be important to provide a tool to rapidly identify early LV dysfunction in daily practice. The aim of this study was to explore the determinants of LV longitudinal indexes in a healthy Italian pediatric population and to provide normative data obtained in a healthy Italian pediatric population. Regression equations for each index were obtained, to allow the calculation of corresponding z scores

Materials and Methods

Results

Discussion