Normative Echocardiographic Left Ventricular Parameters and Reference Intervals in Infants

Research output: Contribution to journalJournal articleResearchpeer-review

  • R. Ottilia B. Vøgg
  • Anne-Sophie Sillesen
  • Jan Wohlfahrt
  • Christian Pihl
  • Anna Axelsson Raja
  • Niels Vejlstrup
  • Jakob B. Norsk
  • Eleni Elia
  • Lynn A. Sleeper
  • Steven D. Colan
  • Iversen, Kasper
  • Heather A. Boyd
  • Bundgård, Henning

Background: In pediatric echocardiography, reference intervals are required to distinguish normal variation from pathology. Left ventricular (LV) parameters are particularly important predictors of clinical outcome. However, data from healthy newborns are limited, and current reference intervals provide an inadequate approximation of normal reference ranges. Objectives: Normative reference intervals and z-scores for 2-dimensional echocardiographic measurements of LV structure and function based on a large group of healthy newborns were developed. Methods: The study population included 13,454 healthy newborns from the Copenhagen Baby Heart Study who were born at term to healthy mothers, had an echocardiogram performed within 30 days of birth, and did not have congenital heart disease. To develop normative reference intervals, this study modeled 10 LV parameters as a function of body surface area through joint modeling of 4 statistical components. Results: Infants in the study population (48.5% were female) had a median body surface area of 0.23 m2 (IQR: 0.22-0.25 m2) and median age of 12.0 days (IQR: 8.0-15.0 days) at examination. All normative reference intervals performed well in both sexes without stratification on infant sex. In contrast, creation of separate reference models for infants examined at <7 days of age and those examined at 7-30 days of age was necessary to optimize the performance of the reference intervals. Conclusions: This study provides normative reference intervals and z-scores for 10 clinical, widely used echocardiographic measures of LV structure and function based on a large cohort of newborns. These results provide highly needed reference material for clinical application by pediatric cardiologists.

Original languageEnglish
JournalJournal of the American College of Cardiology
Volume81
Issue number22
Pages (from-to)2175-2185
Number of pages11
ISSN0735-1097
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
© 2023 American College of Cardiology Foundation

    Research areas

  • cardiovascular growth, echocardiography, normative reference intervals, pediatric, z-scores

ID: 364020476