Reference intervals for the echocardiographic measurements of the right heart in children and adolescents: a systematic review

Lemmer, Carolina Elisabet; Engel, Mark E; Stanfliet, John C.; Mayosi, Bongani M.

doi:10.1186/1476-7120-12-3

Cited by 15 publications

(5 citation statements)

References 56 publications

(136 reference statements)

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“…The existence of DCM has been proposed as evidence of myocardial dysfunction in diabetic patients in the absence of ischemic, valvular or hypertensive heart disease [39]. Despite scarce evidence of established echocardiographic ranges for cardiac dysfunction in adolescence [40], more than 40% and 60% of girls and boys, respectively, showed LV diastolic abnormalities, whereas RV diastolic injury was observed in 14.6% of girls and in 13.3% of boys. Impairment of diastolic but not systolic function was also previously noticed in young with T1DM [41].…”

Section: Discussionmentioning

confidence: 99%

Lipid Biomarkers as Predictors of Diastolic Dysfunction in Diabetes with Poor Glycemic Control

Khedr

Hafez

Lumpuy‐Castillo

et al. 2020

IJMS

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Uncontrolled type-1 diabetes (T1DM) can lead to dyslipidaemia and albuminuria, which may promote cardiovascular injuries. However, some lipidemic factors could be useful in predicting cardiac dysfunction. Seventy-eight adolescents under insulin treatment due to a 6-year history of T1DM and were retrospectively examined. Glycemia, lipidemia, and albuminuria were measured in addition to development of cardiovascular abnormalities Both girls and boys showed higher HbA1c and fasting blood glucose and 27.1% females and 33.3% males exhibited microalbuminuria though their plasma levels of total cholesterol (TC), triglycerides (TG), and low-density lipoproteins (LDL) and high-density lipoproteins (HDL lipoproteins were in the normal range. They exhibited a preserved systolic function, but 50% of females and 66.6% of males had developed diastolic failures. Interestingly, girls with diastolic dysfunction showed significantly lower concentrations of HDL and higher TC/HDL and TG/HDL ratios. In fact, low HDL levels (OR 0.93; 95% CI 0.88–0.99; p = 0.029) and high TC/HDL (OR 2.55; 95% CI 1.9–5.45; p = 0.016) and TG/HDL (OR 2.74; 95% CI 1.12–6.71; p = 0.028) ratios associated with the development of diastolic complications. The cut-off values for HDL, TC/HDL, and TG/HDL were 49 mg/dL, 3.0 and 1.85, respectively. HDL and TC/HDL and TG/HDL ratios may be useful for predicting diastolic dysfunction in girls with uncontrolled T1DM.

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Section: Discussionmentioning

confidence: 99%

Lipid Biomarkers as Predictors of Diastolic Dysfunction in Diabetes with Poor Glycemic Control

Khedr

Hafez

Lumpuy‐Castillo

et al. 2020

IJMS

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“…Right ventricle (RV) volume data were not available at this point, so global RV dilatation Padua Criteria could not be used [7]. RV and LV size, RV function, and LV function age/body size normative values were used to determine abnormal values, in addition to current adult-derived recommendations [17,[20][21][22][23][24][25][26]. A left ventricular ejection fraction (LVEF) of less than 55% was considered abnormal [27].…”

Section: Methodsmentioning

confidence: 99%

Investigating the Accuracy of Quantitative Echocardiographic-Modified Task Force Criteria for Arrhythmogenic Ventricular Cardiomyopathy in Adolescent Male Elite Athletes

et al. 2021

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Athlete preparticipation screening focuses on preventing sudden cardiac death (SCD) by detecting diseases such as arrhythmogenic ventricular cardiomyopathy (AVC), which affects primarily the right ventricular myocardium. Diagnosis may be obscured by physiological remodeling of the athlete heart. Healthy athletes may meet the 2010 Task Force Criteria right ventricular outflow tract (RVOT) dimension cut-offs, questioning the suitability of the modified Task Force Criteria (mTFC) in adolescent athletes. In this study, 67 male adolescent footballers undergoing preparticipation screening were reviewed. All athletes underwent a screening for resting ECG and echocardiogram according to the English FA protocol, as well as cardiopulmonary exercise testing, stress ECG, and exercise echocardiography. Athletes’ right ventricular outflow tract (RVOT) that met the major AVC diagnostic criteria for dilatation were identified. Of 67 evaluated athletes, 7 had RVOT dilatation that met the major criteria, all in the long axis parasternal view measurement. All had normal right ventricular systolic function, including normal free-wall longitudinal strain (ranging from − 21.5 to − 32.7%). Left ventricular ejection fraction ranged from 52 to 67%, without evidence of structural changes. Resting ECGs and cardiopulmonary exercise tests were normal in all individuals. In a series of healthy athletes meeting the major AVC diagnostic criteria for RVOT dilatation, none had any other pathological changes on a detailed screening including ECG, exercise testing, and echocardiography. This report highlights that current AVC echocardiographic diagnosis criteria have limitations in this population.

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“…A z ‐score value of <−2 was considered abnormal. Given the paucity of normal values of FAC and MPI in large cohorts of pediatric patients, a FAC of >35% and MPI of <0.55 were considered normal based on published values in small pediatric controls and normal adult values . Each echocardiogram was also assessed to determine RV systolic function qualitatively as normal, mildly, moderately, or severely decreased.…”

Section: Methodsmentioning

confidence: 99%

Early assessment of right ventricular systolic function after pediatric heart transplant

Harrington

Freud

Woldu

et al. 2018

Pediatric Transplantation

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RV systolic function is important early after HT; however, it has not been critically assessed in children using quantitative measures. The aim of this study was to describe the most validated and commonly used quantitative echocardiographic measures of RV systolic function early after pediatric HT and to assess associations with qualitative function evaluation and clinical factors. RV systolic function was quantified on the first post-HT echocardiogram >24 hours after cardiopulmonary bypass using two-dimensional TAPSE, Tricuspid annular S', FAC, and MPI. In 145 patients (median age 7.6 years), quantitative RV systolic function was markedly abnormal: mean TAPSE z-score -8.43 ± 1.89; S' z-score -4.36 ± 1.22; FAC 24.4 ± 8.34%; and MPI 0.86 ± 0.51. Few patients had normal quantitative function: TAPSE (0%), S' (1.2%), FAC (9.4%), and MPI (28.4%). In contrast, 48.3% were observed as normal by qualitative assessment. Most clinical factors, including diagnosis, pulmonary vascular resistance, posttransplant hemodynamics, inotropic support, and rejection, were not associated with RV function. In this large pediatric HT population, TAPSE, S', FAC, and MPI were strikingly abnormal early post-HT despite reassuring qualitative assessment and no significant association with clinical factors. This suggests that the accepted normal values of these quantitative measures may not apply in the early post-HT period to accurately grade RV systolic function, and there may be utility in adapting a concept of normal reference values after pediatric HT.

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Reference intervals for the echocardiographic measurements of the right heart in children and adolescents: a systematic review

Cited by 15 publications

References 56 publications

Lipid Biomarkers as Predictors of Diastolic Dysfunction in Diabetes with Poor Glycemic Control

Lipid Biomarkers as Predictors of Diastolic Dysfunction in Diabetes with Poor Glycemic Control

Investigating the Accuracy of Quantitative Echocardiographic-Modified Task Force Criteria for Arrhythmogenic Ventricular Cardiomyopathy in Adolescent Male Elite Athletes

Early assessment of right ventricular systolic function after pediatric heart transplant

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