title: Reference values of the mitral annular peak systolic velocity (Sm) in 690 healthy pediatric patients, calculation of Z-score values, and comparison to the mitral annular Plane systolic excursion (MAPSE).
abstract: BACKGROUND
  The mitral annular peak systolic velocity (Sm) is an echocardiographic measurement using tissue Doppler imaging to assess longitudinal left ventricular (LV) systolic function in children and adults. We determined growth-related changes in Sm to establish reference values for the entire pediatric age group.
  
  
  RESULTS
  A prospective study was conducted in a group of 690 healthy pediatric patients (age: 1 day-18 years). We determined the effects of age, sex, and body surface area (BSA) on the Sm values. Regression analysis was used to estimate Sm from age, BSA, and sex. In addition, a correlation of normal Sm with normal age-matched values of the M-mode parameter mitral annular plane systolic excursion (MAPSE) was measured. The Sm ranged from a mean of 5.8 cm/sec (Z-score ±2: 3.6-8.0 cm/sec) in the newborn to 11.8 cm/sec (Z-score ±2: 8.5-15.1 cm/sec) in the 18-year-old adolescent. The Sm values showed a positive correlation with age and BSA with a nonlinear course. There was no significant difference in Sm values between females and males. A significant correlation was found between Sm and MAPSE values.
  
  
  CONCLUSIONS
  Z-scores of Sm values were calculated and percentile charts were established to serve as reference data in patients with congenital heart diseases.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Koestenberger
authors.forename: Bert
authors.initials: B
authors.lastname: Nagel
authors.forename: William
authors.initials: W
authors.lastname: Ravekes
authors.forename: Alexander
authors.initials: A
authors.lastname: Avian
authors.forename: Gerhard
authors.initials: G
authors.lastname: Cvirn
authors.forename: Thomas
authors.initials: T
authors.lastname: Rehak
authors.forename: Andreas
authors.initials: A
authors.lastname: Gamillscheg
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001783:Blood Flow Velocity / Q000502:physiology; D001830:Body Surface Area; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000502:physiology*; D011446:Prospective Studies; D012016:Reference Values; D015203:Reproducibility of Results; D012737:Sex Factors; D013599:Systole; D016277:Ventricular Function, Left / Q000502:physiology
keywords: Z-score; left ventricular systolic function; mitral annular peak systolic velocity; mitral annular plane systolic excursion; pediatric patients; reference values