Corresponding Author:
Pei-Ni Jone MD
Mailing Address:
13123 East 16th Avenue, B100, Aurora, Colorado 80045
Telephone: 720-777-2944
E-mail:
pei-ni.jone@childrenscolorado.org
Background: Three-dimensional echocardiography (3DE) evaluation
of left ventricular (LV) volume and function in pediatrics compares
favorably with cardiac magnetic resonance imaging. A multicenter trial
with automated and semi-automated LV quantification allows for
generation of normative data in large pediatric patients. The aims of
this study were to evaluate the feasibility and reproducibility of
measuring three-dimensional echocardiography (3DE) volumes and function
in pediatric patients in a multicenter trial; to determine if automated
software (without contouring edits) will improve the reproducibility in
volume and function analysis; and thus establish normal z score values
in this unique population.
Methods: Six hundred and ninety-eight healthy children (ages 0
to 18 years) were recruited from 5 centers. Left ventricular (LV) 3DE
was acquired from the 4-chamber view. A vendor independent software
analyzed end-diastolic volume (EDV), end-systolic volume (ESV), stroke
volume (SV), and ejection fraction (EF) using automated and
semi-automated quantification. Feasibility and reproducibility were
assessed. Body surface area (BSA) based z-scores were generated.
Results: Feasibility was 79% (523/658). Reproducibility was
good between centers using the semi-automated quantification.
Reproducibility was decreased using the automated quantification.
Therefore, Z-scores were generated for ESV, EDV, and SV using the
semi-automated method.
Conclusions: 3DE can reliably evaluate LV volumes and EF in
pediatric patients at different centers. We report pediatric Z-scores
for normal LV volumes using the semi-automated method. Further
optimization of technology will be necessary for reliable use of fully
automated quantification by 3DE in children.
Key words: Three dimensional echocardiography, left ventricular
volume, left ventricular function, normal data