Normal percentile curves for left atrial size in healthy children and adolescents

Diaz, Alberto Alejandro; Zócalo, Yanina

doi:10.1111/echo.14286

Cited by 10 publications

(7 citation statements)

References 43 publications

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“…LAV index (LAVi) z-score were calculated using expected means and SDs based on age and sex-specific equations for reference values for healthy children and adults. 36 LAVi z-scores > +2 were considered abnormal. 37 Left ventricle internal diameter end diastole (LVIDd) z-scores were calculated using means and SDs based on normal M mode LVIDd values classified by body surface area (BSA).…”

Section: Discussionmentioning

confidence: 99%

“…16,26,44 This difference is probably due to our pediatric-specific method to calculate LA volume Z scores, which accounted for both age and sex, likely increasing case ascertainment. 36 In our entire cohort, we saw a significant increase in the mean LA volume index over the 2-year study period and explored its correlates.…”

Section: Effect Of Diastolic Parameters On Tricuspid Regurgitant Velo...mentioning

confidence: 96%

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Longitudinal effect of disease‐modifying therapy on left ventricular diastolic function in children with sickle cell anemia

et al. 2023

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Cardiac abnormalities seen in sickle cell anemia (SCA) include diastolic dysfunction, which has been shown to be associated with high morbidity and early mortality. The effect of disease‐modifying therapies (DMT) on diastolic dysfunction is poorly understood. We prospectively evaluated the effects of hydroxyurea and monthly erythrocyte transfusions on diastolic function parameters over 2 years. A total of 204 subjects with HbSS or HbSβ0‐thalassemia (mean age 11 ± 3.7 years), unselected for disease severity, had diastolic function assessed with surveillance echocardiograms twice, 2 years apart. During this 2‐year observation period, 112 participants received DMTs (hydroxyurea, n = 72, monthly erythrocyte transfusions, n = 40), 34 initiated hydroxyurea, and 58 did not receive any DMT. The entire cohort showed an increase in left atrial volume index (LAVi) of 3.40 ± 10.86 mL/m2, p = .001 over 2 years. This increase in LAVi was independently associated with anemia, high baseline E/e′ or LV dilation. Individuals not exposed to DMT were younger (mean age 8.8 ± 2.9 years), but at baseline their prevalence of abnormal diastolic parameters was similar to that of the DMT‐exposed participants who were older (mean age 12 ± 3.8 years). Participants on DMTs saw no improvement in diastolic function over the study period. In fact, participants on hydroxyurea saw a possible worsening in diastolic parameters (14% increase in LAVi and ~5% decrease in septal e′) but also a ~9% decrease in fetal hemoglobin (HbF) levels. Further studies are needed to evaluate if exposure to DMT for a longer duration or achieving higher HbF might be beneficial in alleviating diastolic dysfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Effect Of Diastolic Parameters On Tricuspid Regurgitant Velo...mentioning

confidence: 96%

Longitudinal effect of disease‐modifying therapy on left ventricular diastolic function in children with sickle cell anemia

et al. 2023

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“…Age-related equations were obtained for mean values (MV) and SD. To this end, we implemented parametric regression methods based on fractional polynomials (FPs) (Royston and Wright, 1998), included in the European Reference Values for Arterial Measurements Collaboration Group methodological strategy and already used by our group (Diaz et al, 2018;Díaz et al, 2019Díaz et al, , 2020Zócalo et al, 2020;Bia and Zócalo, 2021). Briefly, fitting FPs age-specific MV and SD regression curves for the different variables (e.g., CCA EDV) were defined using an iterative procedure (generalized least squares).…”

Section: Discussionmentioning

confidence: 99%

Sex- and Age-Related Physiological Profiles for Brachial, Vertebral, Carotid, and Femoral Arteries Blood Flow Velocity Parameters During Growth and Aging (4–76 Years): Comparison With Clinical Cut-Off Levels

Zócalo¹,

Bia²

2021

Front. Physiol.

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Ultrasound-derived blood flow velocity (BFV) levels [e.g., peak systolic velocity (PSV)], intrabeat indexes (e.g., resistive), and intersegment ratios [e.g., internal/common carotid artery (ICA/CCA) PSV ratio] are assessed to describe cardiovascular physiology and health status (e.g., disease severity evaluation and/or risk stratification). In this respect, fixed cut-off values (disregard of age or sex) have been proposed to define “significant” vascular disease from BFV-derived data (parameters). However, the use of single fixed cut-off values has limitations. Accurate use of BFV-derived parameters requires knowing their physiological age-related profiles and the expected values for a specific subject. To our knowledge, there are no studies that have characterized BFV profiles in large populations taking into account: (i) data from different age-stages (as a continuous) and transitions (childhood–adolescence–adulthood), (ii) complementary parameters, (iii) data from different arteries, and (iv) potential sex- and hemibody-related differences. Furthermore, (v) there is little information regarding normative data [reference intervals (RIs)] for BFV indexes.Aims: The aims of this study are the following: (a) to determine the need for age-, body side-, and sex-specific profiles for BFV levels and derived parameters (intrabeat indexes and intersegment ratios), and (b) to define RIs for BFV levels and parameters, obtained from CCA, ICA, external carotid, vertebral, femoral, and brachial arteries records.Methods: A total of 3,619 subjects (3–90 years) were included; 1,152 were healthy (without cardiovascular disease and atheroma plaques) and non-exposed to cardiovascular risk factors. BFV data were acquired. The agreement between left and right data was analyzed (Concordance correlation, Bland–Altman). Mean and SD equations and age-related profiles were obtained for BFV levels and parameters (regression methods; fractional polynomials).Results: Left and right body-side derived data were not always equivalent. The need for sex-specific RIs was dependent on the parameter and/or age considered. RIs were defined for each studied artery and parameter. Percentile curves were compared with recommended fixed cut-off points. The equations for sex, body-side, and age-specific BFV physiological profiles obtained in the large population (of children, adolescents, and adults) studied were included (spreadsheet formats), enabling to determine for a particular subject, the expected values and potential data deviations.

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“…To this end, parametric regression methods based on fractional polynomials (FPs) were applied. These were described by Royston and Wright [45], considered in the European Reference Values for Arterial Measurements Collaboration Group methodological strategy, and already used by our group to define RIs for hemodynamic, ventricular, atrial and arterial parameters [20,25,[46][47][48]. Briefly, fitting FPs age-specific MV and SD regression curves for the different variables were defined using an iterative procedure (generalized least squares).…”

Section: Plos Onementioning

confidence: 99%

Age- and sex-related profiles for macro, macro/micro and microvascular reactivity indexes: Association between indexes and normative data from 2609 healthy subjects (3-85 years)

Zócalo

2021

PLoS ONE

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Vascular reactivity (VR), defined as blood vessels’ capability to actively modify the diameter and flow resistances can be non-invasively assessed analyzing vascular response to forearm occlusion. Several VR indexes can be quantified: (i) ´microvascular´, which consider variables that depend almost exclusively on changes in distal resistances, (ii)´ macrovascular´, that evaluate the changes in brachial artery (BA) diameter, adjusting for blood flow stimulus, and (iii) ´macro/micro´, whose values depend on the micro and macrovascular response without discriminating each one´s contribution. VR indexes could not be associated. Many VR indexes have been used without availability of adequate normative data (reference intervals, RIs). Aims: (1) to evaluate macro, macro/micro and micro VR indexes obtained in a cohort of healthy children, adolescents and adults, (2) to evaluate the association between VR indexes, (3) to determine the need for age and/or sex-specific RIs, and (4) to define RIs for VR indexes. Methods: Ultrasound (B-mode/Doppler) and automatic computerized analysis were used to assess BA diameter, blood flow velocity and distal resistances, at rest and in conditions of decreased and increased blood flow. Macro, macro/micro and micro VR indexes were quantified (n = 3619). RIs-subgroups were defined according to European Reference Values for Arterial Measurements Collaboration Group (n = 1688, 3–84 years) and HUNT3-Fitness Study Group (n = 2609, 3–85 years) criteria. Mean value and standard deviation equations were obtained for VR indexes. The need for age or sex-specific RIs was analyzed. Percentile curves were defined and data were compared with those obtained in other populations. Conclusion: Macro and macro/micro VR indexes showed no association (or it was very weak) with microvascular indexes. Age- and sex-related profiles and RIs for macro, macro/micro and micro VR indexes were defined in a large population of healthy subjects (3–85 y). Equations for mean, standard deviation and percentiles values (year-to-year) were included in text and spreadsheet formats.

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Normal percentile curves for left atrial size in healthy children and adolescents

Cited by 10 publications

References 43 publications

Longitudinal effect of disease‐modifying therapy on left ventricular diastolic function in children with sickle cell anemia

Longitudinal effect of disease‐modifying therapy on left ventricular diastolic function in children with sickle cell anemia

Sex- and Age-Related Physiological Profiles for Brachial, Vertebral, Carotid, and Femoral Arteries Blood Flow Velocity Parameters During Growth and Aging (4–76 Years): Comparison With Clinical Cut-Off Levels

Age- and sex-related profiles for macro, macro/micro and microvascular reactivity indexes: Association between indexes and normative data from 2609 healthy subjects (3-85 years)

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