title: Reference values of the right ventricular outflow tract systolic excursion in 711 healthy children and calculation of z-score values.
abstract: OBJECTIVE
  Quantitative determination of right ventricular (RV) function has gained more interest over the last years. The RV outflow tract systolic excursion (RVOT SE) has been recently proposed as an echocardiographic tool to assess RV systolic function in adults. We aimed to determine growth-related changes of RVOT SE in children and to establish references values.
  
  
  METHODS
  A prospective study was conducted in a group of 711 healthy paediatric patients (age: 1 day to 18 years). We determined the effects of age and body surface area (BSA) on RVOT SE values. RVOT SE values were further correlated with the established RV systolic function parameters tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular peak systolic velocity (S').
  
  
  RESULTS
  The RVOT SE ranged from a mean of 3.4 mm in neonates to 9.5 mm in 18-year-old adolescents. The RVOT SE values showed a positive correlation with age (r = 0.90, P < 0.001) and BSA (r = 0.91, P < 0.001). A significant positive correlation was seen between RVOT SE and TAPSE (r = 0.93, P < 0.001) and also between RVOT SE and S' (r = 0.86, P < 0.001) in our patients.
  
  
  CONCLUSIONS
  RVOT SE provides a simple measure and, in combination with long-axis excursion parameters TAPSE and S', a comprehensive assessment of RV systolic function. Z-scores of RVOT SE values were calculated, and percentile charts were established to serve as reference data.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria martin.koestenberger@medunigraz.at koestenbergerm@gmx.at.
authors.forename: Martin
authors.initials: M
authors.lastname: Koestenberger
authors.affiliation: Division of Pediatric Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: William
authors.initials: W
authors.lastname: Ravekes
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria.
authors.forename: Bert
authors.initials: B
authors.lastname: Nagel
authors.affiliation: Institute for Medical Informatics, Statistics and Documentation, Medical University Graz, Graz, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Avian
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria.
authors.forename: Bernd
authors.initials: B
authors.lastname: Heinzl
authors.affiliation: Institute of Physiological Chemistry, Centre of Physiological Medicine, Medical University Graz, Graz, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Cvirn
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Fritsch
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fandl
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Rehak
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Gamillscheg
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012016:Reference Values; D013599:Systole / Q000502:physiology; D016278:Ventricular Function, Right / Q000502:physiology*
keywords: Right ventricular outflow tract systolic excursion; age; body surface area; paediatric patients; reference values; right ventricular systolic function; z-score