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Evaluation of left ventricular volumes in the early neonatal period using three-dimensional echocardiography

Published online by Cambridge University Press:  29 July 2013

Hiroyuki Nagasawa
Hiroyuki Nagasawa*
Affiliation:
Department of Neonatology, Gifu Prefectural General Medical Center, Gifu, Japan
*
Correspondence to: H. Nagasawa, Department of Neonatology, Gifu Prefectural General Medical Center, 4-6-1 Noisshiki, Gifu, 500-8717, Japan. Tel: 81-58-246-1111; Fax: 81-58-247-3748; E-mail: hironag@ccn2.aitai.ne.jp
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Abstract

Background

Awareness about normal cardiac volumes in the neonatal period is very important for understanding the cardiac function; however, the small cardiac size of neonates makes it difficult to perform invasive examinations. Three-dimensional echocardiography is used to evaluate cardiac volumes in children. However, no studies using this method have examined left ventricular volumes in neonates during the early neonatal period.

Methods

The study group consisted of 255 normal neonates. Comparisons of the stroke volume calculated according to the velocity–time integral and Pombo method were made.

Results

The volumes in both end-diastole and end-systole and the stroke volume gradually decreased over time after birth. Participants with continuous a persistent ductus arteriosus flow had higher stroke volumes than those without persistent ductus arteriosus. The average end-diastolic volume per body surface area (m2) was 30.61 ml/m2 in boys and 29.80 ml/m2 in girls, whereas the ventricular end-systolic volume was 12.89 ml/m2 in boys and 12.80 ml/m2 in girls among the participants without persistent ductus arteriosus. The average stroke volume was 17.70 ml/m2 in boys and 17.00 ml/m2 in girls. Statistically significant gender differences were observed in the end-diastolic volume (p = 0.0053), stroke volume (p < 0.0001), and ejection fraction (p = 0.039). The cardiac index was calculated to be 2.04 L/minute/m2 in boys and 1.95 L/minute/m2 in girls, which was significantly lower than that calculated using the velocity–time integral and Pombo method (p < 0.0001).

Conclusions

Significant gender differences in the end-diastolic volume, stroke volume, and ejection fraction at birth were revealed. The cardiac index in the early neonatal period was found to be relatively smaller than what had previously been recognised.

Keywords

Left ventricleend-diastolic volumeend-systolic volumestroke volumenormal neonategender differences
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 4 , August 2014 , pp. 685 - 693
Copyright
Copyright © Cambridge University Press 2013 

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References

1. Nagasawa, H, Arakaki, Y, Yamada, O, Nakajima, T, Kamiya, T. Longitudinal observations of left ventricular end-diastolic dimension in children using echocardiography. Pediatr Cardiol 1996; 17: 169–174.CrossRefGoogle ScholarPubMed
2. Mertens, L, Istvan, S, Marek, J, et al. Targeted neonatal echocardiography in the neonatal intensive care unit: practice guidelines and recommendations for training. J Am Soc Echocardiogr 2011; 24: 1057–1078.CrossRefGoogle ScholarPubMed
3. Nagasawa, H. Novel regression equations of left ventricular dimensions in infants less than 1 year of age and premature neonates obtained from echocardiographic examination. Cardiol Young 2010; 20: 526–531.CrossRefGoogle ScholarPubMed
4. Nagasawa, H, Arakaki, Y. Identification of gender differences in the thickness of the left ventricular wall by echocardiography in children. Cardiol Young 2002; 12: 37–43.CrossRefGoogle ScholarPubMed
5. Foran, AM, Fitzpatrick, JA, Allsop, J, et al. Three-tesla cardiac magnetic resonance imaging for preterm infants. Pediatr 2007; 120: 78–83.CrossRefGoogle ScholarPubMed
6. Acar, P, Marx, GR, Salibe, Z, Sidi, D, Kachaner, J. Three-dimensional echocardiographic measurement of left ventricular stroke volume in children: comparison with Doppler method. Pediatr Cardiol 2001; 22: 116–120.CrossRefGoogle ScholarPubMed
7. Cohen, J. Statistical Power Analysis for the Behavioral Sciences, 2nd edn, Lawrence Erlbaum Associates, Hillsdale, NJ, 1988: 52–66.Google Scholar
8. Pombo, JF, Troy, BL, Russell, RO. Left ventricular volumes and ejection fraction by echocardiography. Circulation 1971; 43: 480–490.CrossRefGoogle ScholarPubMed
9. Haycock, GB, Schwartz, GJ, Wisotsky, DH. Geometric method for measuring body surface area: a height–weight formula validated in infants, children, and adults. J Pediatr 1978; 93: 62–66.CrossRefGoogle ScholarPubMed
10. DuBois, D, DuBois, EF. Clinical calorimetry. X. A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med 1916; 17: 863–871.CrossRefGoogle Scholar
11. Mandelbaum-Isken, VH, Linderkamp, O. Cardiac output by pulsed Doppler in neonates using the apical windows. Pediatr Cardiol 1991; 12: 13–16.CrossRefGoogle Scholar
12. Patel, N, Dodsworth, M, Mills, JF. Cardiac output measurement in newborn infants using the ultrasonic cardiac monitor: an assessment of agreement with conventional echocardiography, repeatability and new user experience. Arch Dis Child Fetal Neonatal Ed. 2011; 96: F206–F211.CrossRefGoogle Scholar
13. Friedberg, MK, Su, X, Tworetzky, W, Soriano, BD, Powell, AJ, Marx, GR. Validation of 3D echocardiographic assessment of left ventricular volumes, mass, and ejection fraction in neonates and infants with congenital heart disease: a comparison study with cardiac magnetic resonance imaging. Circ Cardiovasc Imaging 2010; 3: 735–742.CrossRefGoogle Scholar
14. Lytrivi, ID, Bhatla, P, Ko, HH, et al. Normal value for left ventricular volume in infants and young children by the echocardiographic subxiphoid five-sixth area by length (bullet) method. J Am Soc Echocardiogr 2011; 24: 214–218.CrossRefGoogle ScholarPubMed