Journal of the American Society of Echocardiography
Clinical InvestigationEchocardiography in ChildrenEchocardiographic Nomograms for Ventricular, Valvular and Arterial Dimensions in Caucasian Children with a Special Focus on Neonates, Infants and Toddlers
Section snippets
Subject Enrollment
All consecutive Caucasian neonates, infants, and toddlers (age range, 0 days to 36 months) evaluated in the outpatient of the Pediatric Cardiology Department for screening for CHD at Fondazione G. Monasterio CNR-Regione Toscana of Massa eligible for inclusion in the study were prospectively enrolled.
Our department provides an outpatient service reserved for neonatologists from nearby hospitals and pediatricians in our territory to refer children with suspicion for congenital cardiac defects for
Population Description
The study population consisted of 445 consecutive children (226 male, 219 female) prospectively enrolled from November 2011 to July 2013 who met the inclusion and exclusion criteria. The mean age was 5.5 ± 7.9 months (median, 1.9 months; interquartile range, 0.4–7.8 months; range, 0 days to 36 months). Ninety-one subjects (20.4%) were premature and 26.7% had cesarean deliveries. Body weight ranged from 1.3 to 16.0 kg (median, 4.7 kg; interquartile range, 3.1–8.0 kg). Height ranged from 40.8 to
Discussion
The importance of accurate pediatric nomograms has recently been addressed by various investigators,1, 2, 3, 4, 17, 33, 34 with recommendations to use Z scores for various reasons. Current pediatric nomograms, however, present a few methodologic limitations, particularly in terms of data in neonates.
In the present study, we have established nomograms for ventricular, valvular, and arterial dimensions in a wide population of healthy neonates, infants, and toddlers. These nomograms introduce some
Conclusions
Our nomograms provide useful quantitative tools for clinicians to evaluate and manage neonates, infants, and toddlers with congenital and acquired heart disease.
In addition, this work offers a solid methodologic design and a distinct advantage by including measurements for several cardiac structures (such as the aortic arch at different sites, the pulmonary arteries, and the inferior vena cava) that have not been well evaluated in previous studies. Further studies are needed to evaluate other
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