TY - JOUR
T1 - Echocardiographic Left Ventricular Z-Score Utility in Predicting Pulmonary-Systemic Flow Ratio in Children with Ventricular Septal Defect or Patent Ductus Arteriosus
AU - Sumitomo, Naofumi F.
AU - Kodo, Kazuki
AU - Maeda, Jun
AU - Miura, Masaru
AU - Yamagishi, Hiroyuki
N1 - Publisher Copyright:
© 2022 Japanese Circulation Society. All rights reserved.
PY - 2022
Y1 - 2022
N2 - Background: The correlation between the Z-score of the left ventricular (LV) diameter and the LV volume-overload due to pulmonary over-circulation in children with ventricular septal defect (VSD) or patent ductus arteriosus (PDA) remains unclear. Methods and Results: The present, retrospective study enrolled 70 children (aged 0.3–16.8 years; 33 males, 37 females) with a diagnosis of isolated VSD and/or PDA who underwent cardiac catheterization (CC) between 2015 and 2019. Patients with chromosomal/genetic anomalies, growth disorder, right-ventricular enlargement or other conditions causing LV enlargement were excluded. Echocardiographic parameters were retrospectively evaluated from the medical records, converted to a Z-score, then compared with CC data. The pulmonary-systemic flow ratio on CC (cQp/Qs) correlated significantly with the Z-score of both the LV end-diastolic diameter (Zd) (r=0.698, P<0.0001) and LV end-systolic diameter (r=0.593, P<0.0001). Regression analysis and curve-fitting were used to predict the cQp/Qs based on the Zd, and a significant regression equation was found on cubic regression (R2 of 0.524, P<0.0001) showing a strong correlation with the cQp/Qs (r=0.724, P<0.0001). Conclusions: The Z-score of the LV diameter can be a useful, non-invasive marker for evaluating LV volume overload and determining the surgical indications in children with VSD or PDA because of its strong correlation with the cQp/Qs.
AB - Background: The correlation between the Z-score of the left ventricular (LV) diameter and the LV volume-overload due to pulmonary over-circulation in children with ventricular septal defect (VSD) or patent ductus arteriosus (PDA) remains unclear. Methods and Results: The present, retrospective study enrolled 70 children (aged 0.3–16.8 years; 33 males, 37 females) with a diagnosis of isolated VSD and/or PDA who underwent cardiac catheterization (CC) between 2015 and 2019. Patients with chromosomal/genetic anomalies, growth disorder, right-ventricular enlargement or other conditions causing LV enlargement were excluded. Echocardiographic parameters were retrospectively evaluated from the medical records, converted to a Z-score, then compared with CC data. The pulmonary-systemic flow ratio on CC (cQp/Qs) correlated significantly with the Z-score of both the LV end-diastolic diameter (Zd) (r=0.698, P<0.0001) and LV end-systolic diameter (r=0.593, P<0.0001). Regression analysis and curve-fitting were used to predict the cQp/Qs based on the Zd, and a significant regression equation was found on cubic regression (R2 of 0.524, P<0.0001) showing a strong correlation with the cQp/Qs (r=0.724, P<0.0001). Conclusions: The Z-score of the LV diameter can be a useful, non-invasive marker for evaluating LV volume overload and determining the surgical indications in children with VSD or PDA because of its strong correlation with the cQp/Qs.
KW - Children
KW - Congenital heart disease
KW - Echocardiography
KW - Left ventricular volume over-load
KW - Z-score
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U2 - 10.1253/circj.CJ-21-0559
DO - 10.1253/circj.CJ-21-0559
M3 - Article
C2 - 34657926
AN - SCOPUS:85122078293
VL - 86
SP - 128
EP - 135
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 1
ER -