Valores de referencia (Z-score) de diámetros de porción de entrada y trabecular del ventrículo derecho: primera descripción en población pediátrica española sana
- Luisa García-Cuenllas Alvarez
- F. Gutiérrez-Larraya
- E. Maroto Álvaro
- Ana Rodríguez López Domingo
- Pedro Luis Sánchez Fernández
- Luis García-Guereta
- Félix Lorente Toledano
ISSN: 1695-4033, 1696-4608
Datum der Publikation: 2020
Ausgabe: 92
Nummer: 3
Seiten: 147-155
Art: Artikel
Andere Publikationen in: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )
Zusammenfassung
Introduction and objectives Right ventricle (RV) measurements are crucial for certain congenital heart diseases and various cardiovascular conditions. Echocardiographic RV diameters are especially useful for its assessment. Paediatric echocardiographic data standardisation in normal subjects is complex, scarce, and heterogeneous. The aim of this study was to establish reliable and reproducible echocardiographic reference values (Z-score) of RV diameters in a healthy Spanish paediatric cohort. Methods A multicentre study was conducted on 661 healthy subjects (age range 0-18 years, 43.5% female). Several regression models were tested to examine the relationship between RV diameters and biometric variables. Heteroscedasticity and residual associations (Shapiro-Wilk and Breusch-Pagan tests) and confounding factors (gender, age, inter/intraobserver agreement) were considered for an unbiased standardisation. Results Structured Z-scores were computed for each RV diameter. Predicted mean value for each diameter was determined according to age, weight, height, and different body surface area. The Haycock formula provided the best fit for basal, midcavity, and longitudinal diameters (R2 0.81; 0.82; 0.9). Confounders were not significant, and therefore not included in final models (inter/intraobserver agreement > 0.9). Conclusions This study reports reference values for echocardiographic RV diameters from a Spanish healthy paediatric cohort using a rigorous statistical design. These Z-scores partly cover a gap in current paediatric cardiology and represent a relevant diagnostic tool for clinical practice, as well as a useful guide to decision making at any paediatric stage.