title: Echocardiographic nomograms for chamber diameters and areas in Caucasian children.
abstract: BACKGROUND
  Although a quantitative evaluation of cardiac chamber dimensions in pediatric echocardiography is often important, nomograms for these structures are limited. The aim of this study was to establish reliable echocardiographic nomograms of cardiac chamber diameters and areas in a wide population of children.
  
  
  METHODS
  A total of 1,091 Caucasian Italian healthy children (age range, 0 days to 17 years; 44.8% female) with body surface areas (BSAs) ranging from 0.12 to 1.8 m(2) were prospectively enrolled. Twenty-two two-dimensional and M-mode measurements of atrial and ventricular chamber diameters and areas were performed. Models using linear, logarithmic, exponential, and square-root relationships were tested. Heteroscedasticity was tested by the White test and the Breusch-Pagan test. Age, weight, height, and BSA, calculated by the Haycock formula, were used as the independent variables in different analyses to predict the mean value of each echocardiographic measurement. The influence of various confounders, including gender, type of delivery, prematurity, and interobserver variability, was also evaluated. Structured Z scores were then computed.
  
  
  RESULTS
  The Haycock formula provided the best fit and was used when presenting data as predicted values (mean ± 2 SDs) for a given BSA and within equations relating echocardiographic measurements to BSA. Confounders were not included in the final models, because they did not show significant effects for most of the measurements.
  
  
  CONCLUSIONS
  Echocardiographic reference values are presented for chamber area and diameters, derived from a large population of healthy children. These data partly cover a gap in actual pediatric echocardiographic nomograms. Further studies are required to reinforce these data, as well as to evaluate other parameters and ethnicities.
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Italy. Electronic address: cantinotti@ftgm.it.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Cantinotti
authors.affiliation: Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Scalese
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Murzi
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Italy.
authors.forename: Nadia
authors.initials: N
authors.lastname: Assanta
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Italy.
authors.forename: Isabella
authors.initials: I
authors.lastname: Spadoni
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Italy.
authors.forename: Vittoria
authors.initials: V
authors.lastname: De Lucia
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Crocetti
authors.affiliation: Department of Cardiology USL 9, Grosseto, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cresti
authors.affiliation: Department of Cardiology, Siena University, Siena, Italy.
authors.forename: Milena
authors.initials: M
authors.lastname: Gallotta
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Marotta
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Italy.
authors.forename: Karin
authors.initials: K
authors.lastname: Tyack
authors.affiliation: Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Molinaro
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Italy; Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Iervasi
mesh_terms: D000293:Adolescent; D000465:Algorithms; D016275:Atrial Function / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D003196:Computer Graphics; D003198:Computer Simulation; D004452:Echocardiography / Q000379:methods / Q000592:standards; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000208:ethnology; D008297:Male; D008955:Models, Cardiovascular; D015233:Models, Statistical; D009716:Numerical Analysis, Computer-Assisted; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016276:Ventricular Function / Q000502:physiology*; D044465:White People
keywords: Children; Echocardiography; Nomograms