title: Reference values and calculation of z-scores of echocardiographic measurements of the normal pediatric right ventricle.
abstract: Determination of right ventricular (RV) size and function has gained more interest in recent years in adults and children, especially in patients with congenital heart disease. Data on normal RV size parameters in children are scant. The aim of this study was to investigate growth-related changes in RV internal dimensions in a healthy pediatric cohort and the predictive value of RV parameters in identifying enlarged right ventricles in children with secundum-type atrial septal defects (ASD). A prospective study was conducted in a group of 576 healthy children (aged 1 day to 18 years) and 37 children (aged 1.4 to 17.7 years) with moderate-sized to large ASDs. The effects of age, body length, body weight, and body surface area were determined on the following RV parameters: end-diastolic basal diameter, end-diastolic midcavity diameter, end-diastolic length, end-systolic length, end-diastolic area, and end-systolic area. The predictive value of normal values stratified for age, body weight, body length, and body surface area was tested in children with ASDs. RV end-diastolic basal diameter, end-diastolic midcavity diameter, end-diastolic length, end-systolic length, end-diastolic area, and end-systolic area showed positive correlations with age, body length, body surface area, and body weight. In this population, RV z scores showed high specificity for detecting patients with ASDs, with sensitivity up to 89%, especially in children <8 years of age. In conclusion, the normal ranges of pediatric RV internal dimensions are provided. The z scores of these RV parameters were also calculated. Normal RV z scores might be important predictors in identifying enlarged right ventricles in patients with ASDs.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria. Electronic address: martin.koestenberger@medunigraz.at.
authors.forename: Martin
authors.initials: M
authors.lastname: Koestenberger
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: Division of Pediatric Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: William
authors.initials: W
authors.lastname: Ravekes
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: Ante
authors.initials: A
authors.lastname: Burmas
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria.
authors.forename: Gernot
authors.initials: G
authors.lastname: Grangl
authors.affiliation: Institute of Physiological Chemistry, Center 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: Andreas
authors.initials: A
authors.lastname: Gamillscheg
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012016:Reference Values; D015203:Reproducibility of Results; D016278:Ventricular Function, Right / Q000502:physiology*