The Influence of Heart Rate and Age on the Systolic and Diastolic Time Intervals in Children

Spitaels, S E; Arbogast, R; Fouron, Jean‐Claude; Davignon, A

doi:10.1161/01.cir.49.6.1107

Cited by 54 publications

(26 citation statements)

References 20 publications

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“…In this study we found the PEP/LVET ratio to be essentially independent of both age and heart rate, as was found in the study of Spitaels et al 5 and as has been found in adults.' Although by the statistical methods used, regression equations were derived relating the PEP/LVET ratio to heart rate in males and to age in females, the correlation in both cases is very low and probably does not justify the use of these equations in practice.…”

Section: The Pep/lvet Ratiosupporting

confidence: 90%

“…This was made possible by the work of Weissler and his associates, who established regression equations for the normal intervals in relation to heart rate in adults.' There are only a few studies, however, on systolic time intervals in children, and these studies differ in the techniques used and have had conflicting results in the normal standards relative to heart rate and age.2 5 In the present study we have used the precise techniques established for adults by Weissler and his associates' 6 to derive regression equations for systolic time intervals in normal children to be used as reliable standards for the assessment of left ventricular performance in this age group.…”

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confidence: 99%

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Systolic time intervals in children: normal standards for clinical use.

Cantor¹,

Wanderman²,

Karolevitch³

et al. 1978

Circulation

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SUMMARY Systolic time intervals were measured in 253 normal children, with careful attention to precise recording and measuring techniques, to derive regression equations which could be used as reliable standards for clinical assessment of left ventricular performance in this age group.Using stepwise regression analysis, a highly significant correlation was found for electromechanical systole (QS2) and for left ventricular ejection time (LVET) with heart rate alone in both males and females, and age was not found to be a relevant variable. Similarly, for the preejection period (PEP) in males, heart rate was the only relevant variable. PEP in females showed a small but significant influence of age in addition to heart rate; in practice, this small influence can be neglected. Regression equations relating each of the systolic time intervals to heart rate alone were therefore derived for clinical use. The PEP/LVET ratio was found to be only weakly correlated with heart rate in males and with age in females, and in practice can be considered to be independent of these variables. The mean value of the PEP/LVET ratio and its standard deviation (0.30 ± 0.04) can therefore be used for all children.We found that satisfactory recording of systolic time intervals can be obtained with little difficulty in almost all children using the techniques described. The method is therefore practical for clinical use in children, as it is in adults, and the normal standards derived in this study can serve as a reliable basis for its application.THE USE OF SYSTOLIC TIME INTERVALS as a simple and reliable method for clinical assessment of left ventricular performance in adults has become widespread in recent years. This was made possible by the work of Weissler and his associates, who established regression equations for the normal intervals in relation to heart rate in adults.' There are only a few studies, however, on systolic time intervals in children, and these studies differ in the techniques used and have had conflicting results in the normal standards relative to heart rate and age.2 5 In the present study we have used the precise techniques established for adults by Weissler and his associates' 6 to derive regression equations for systolic time intervals in normal children to be used as reliable standards for the assessment of left ventricular performance in this age group. Methods SubjectsA total of 253 children were tested, 138 males and 115 females. Their ages ranged from 1 month-13 years. They were divided into seven age groups as shown in figure 1.All subjects were normal, healthy children. A physical examination and ECG were performed on the

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Section: The Pep/lvet Ratiosupporting

confidence: 90%

mentioning

confidence: 99%

Systolic time intervals in children: normal standards for clinical use.

Cantor¹,

Wanderman²,

Karolevitch³

et al. 1978

Circulation

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“…18 Various authors have shown that heart rate is the dominant factor influencing cardiac time intervals. 19 The differential effect of heart rate on systolic versus diastolic duration may be a mechanism for cardiac dysfunction and a therapeutic target.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Implications of the Systolic to Diastolic Duration Ratio in Children With Idiopathic or Familial Dilated Cardiomyopathy

Mondal

Slorach

Manlhiot

et al. 2014

Circ: Cardiovascular Imaging

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All children, 0 to 18 years of age, registered in the pediatric heart failure database with a diagnosis of idiopathic, genetic, or familial DCM and who received their initial echocardiogram at our institution Background-Childhood dilated cardiomyopathy (DCM) carries high morbidity and mortality. The echocardiographic systolic to diastolic (S:D) duration ratio, an indicator of global cardiac performance, is elevated in DCM; however, its prognostic implications have not been investigated in this population. Methods and Results-We investigated systolic and diastolic durations and the resultant S:D ratio using pulsed tissue Doppler imaging in children with idiopathic or familial DCM. We studied serial echocardiograms from presentation until the last follow-up echo. Results were compared with heart rate-matched controls and between DCM subgroups based on an acute or insidious presentation. The association between S:D ratio and death or need for transplant was analyzed. All analyses were adjusted for repeated measures per patient. We studied 200 serial echocardiograms of 48 children with DCM (7.0±6.0 years) and 25 controls. Adjusted for repeated measures through a compound symmetry covariance structure, the S:D ratio was higher in DCM patients (−0.425 [0.072]; P<0.001) because of shortened diastole. A S:D ratio >1.2 at presentation and on serial evaluation was associated with a hazard ratio of 10.5 (95% confidence interval, 3.9-27.8; P<0.001) for death or transplant. In combined multivariable analysis, a S:D ratio >1.2 remained significantly associated with hazard of death/transplant (hazard ratio, 9.1; P=0.04) after adjustment for ejection fraction (hazard ratio: 2.2 per −10%; P<0.001). Conclusions-A high S:D ratio is associated with increased risk for death or need for transplant in children with DCM across the spectrum of heart rates and may be a useful prognostic index for serial evaluation of children with DCM.(Circ Cardiovasc Imaging. 2014;7:773-780.)

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“…PEP and LVET are easily corrected for changes in pulse rate [22,23,28,38]. The quotient PEP/LVET is less HR-dependent [6,14,38] and has been considered to be the single most useful index of left ventricular performance from the systolic time intervals [14].…”

Section: Discussionmentioning

confidence: 99%

Effects of dobutamine on left ventricular performance in newborns as determined by systolic time intervals

et al. 1987

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To evaluate the effects of dobutamine on myocardial function in newborns, left ventricular systolic time intervals (STI) - normalized pre-ejection period (PEPI), normalized left ventricular ejection time (LVETI) and pre-ejection period to left ventricular ejection time ratio (PEP/LVET) - were assessed by echocardiography in 18 newborns treated with dobutamine for clinically diagnosed heart failure. Examinations were performed prior to and 30 min after starting dobutamine infusion (7.5 or 10 micrograms/kg per min). Patients were assigned to two groups according to their PEP/LVET prior to dobutamine administration: group I (n = 9) with pre-treatment PEP/LVET less than or equal to 0.35 and group II (n = 9) with pre-treatment PEP/LVET greater than 0.35. While there was no change of STI in group I, dobutamine infusion resulted in a significant decrease in PEPI (from 102 +/- 4.8 to 87.8 +/- 4.2; mean +/- SEM; P less than 0.01) and of PEP/LVET (from 0.56 +/- 0.05 to 0.45 +/- 0.05; mean +/- SEM; P less than 0.01) and in a significant increase of LVETI (from 237.6 +/- 5.6 to 253.3 +/- 5.2; mean +/- SEM; P less than 0.01) in group II. Heart rate increased significantly in both groups. Left ventricular end-diastolic dimension, also assessed by echocardiography, did not change in the eight studies performed. An increase in mean arterial pressure was found in three out of five newborns of group II and in one out of four patients in group I. It is concluded that dobutamine can improve cardiac performance in newborns with impaired left ventricular function. This effect is probably due to an improvement in myocardial contractility.

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The Influence of Heart Rate and Age on the Systolic and Diastolic Time Intervals in Children

Cited by 54 publications

References 20 publications

Systolic time intervals in children: normal standards for clinical use.

Systolic time intervals in children: normal standards for clinical use.

Prognostic Implications of the Systolic to Diastolic Duration Ratio in Children With Idiopathic or Familial Dilated Cardiomyopathy

Effects of dobutamine on left ventricular performance in newborns as determined by systolic time intervals

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