ECHO 2013 / Pediatric Echocardiography Overview of Quantification and Lessons Learned
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Pediatric Quantification Methods
• LV size and function
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–M-mode vs. 2D measurements
•lateral motion
Pediatric Quantification Methods
• LV size and function
– M-mode vs. 2D measurements
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•accuracy
•reproducibility
Pediatric Quantification Methods
Lopez et al. JASE 2010
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• Aortic dimensions
Pediatric Quantification Methods
Lopez et al. JASE 2010
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•Aortic dimensions
–2D, inner edge-to-inner edge
–Maximum dimension (mid-systole)
Boston |
Roman et al. Am J Cardiol 1989 |
Questions Remaining
• Clinical Significance
Lang et al. JASE 2005
Questions Remaining
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• Effects of gender and race: fat free mass
Circulation 2008
Questions Remaining
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• Vendor-specific data
JASE 2010
–mean differences of PWTD velocities between GE and Philips were relatively minor
–absolute percentage differences were high, so that the same ultrasound system should be used for serial tests
Questions Remaining
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•Laboratory systematic bias
Circulation 2001
Summary
•Guidelines exist for a pediatric echocardiogram and quantification methods
•Cardiovascular structures vary with hemodynamic state and body size
•Z-scores based on body surface area are currently the best method for adjusting to body size
Summary
•Discrepancies exist between pediatric and adult quantification methods
•Questions remaining
–Determination of clinical significance
–Effects of gender and race: role of fat free mass
–Importance of vendor for newer measurements
–Importance of inter-laboratory systematic bias