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. The aim of this study
was to establish from a multicenter, normal pediatric z-score values of
3DE left ventricular volumes and function.
Methods: Six hundred and ninety-eight healthy children (ages 0
to 18 years) were recruited from five centers. 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 semi-automated quantification. Body surface
area (BSA) based z-scores were generated. Intraobserver and
interobserver variability were calculated using intraclass correlation
(ICC) and repeatability coefficient (RC).
Results: Z-scores were generated for ESV, EDV, and SV. The ICC
for intraobserver variability for EDV, ESV, and SV were 0.99, 0.99, and
0.99 respectively. The ICC for interobserver variability for EDV, ESV,
and SV were 0.98, 0.94, and 0.98 respectively. The RC for intraobserver
and interobserver variability for LV EF was 4.39% (95% CI: 3.01, 5.59)
and interobserver was 7.08% (95%CI: 5.51, 8.42).
Conclusions: We report
pediatric Z-scores for normal LV volumes using the semi-automated method
from five centers, enhancing its generalizability. 3DE evaluation of LV
volumes and EF in pediatric patients is highly reproducible.
Key words: Three-dimensional echocardiography, left ventricular
volume, left ventricular function, normal data