Alternative to body surface area as a solution to correct systematic bias in pediatric echocardiography Z scores

2021 ◽  
Author(s):  
Virginie Plante ◽  
Laurence Gobeil ◽  
Wei Ting Xiong ◽  
Moustapha Touré ◽  
Nagib Dahdah ◽  
...  
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Systematic Bias ◽  
Z Scores ◽  
Pediatric Echocardiography

Clinical implications of mitral valve geometric alterations in children with dilated cardiomyopathy

2015 ◽  
Vol 26 (7) ◽  
pp. 1365-1372 ◽  
Author(s):  
Taiyu Hayashi ◽  
Ryo Inuzuka ◽  
Takahiro Shindo ◽  
Hiroshi Ono ◽  
Yukihiro Kaneko ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Dilated Cardiomyopathy ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Left Ventricular ◽  
Z Scores ◽  
Mitral Valve Geometry ◽  
Secondary Mitral Regurgitation

AbstractWe aimed to elucidate the relationship between severity of secondary mitral regurgitation and mitral valve geometry in children with dilated cardiomyopathy. The medical records of 16 children with dilated cardiomyopathy (median age, 1.2 years; range, 0.4–12.3 years) were reviewed. Mitral valve geometry was evaluated by measuring coaptation depth using echocardiographic apical four-chamber views at the initial presentation. Patients were dichotomised according to the mitral regurgitation severity: patients with moderate or severe secondary mitral regurgitation (n=6) and those with mild secondary mitral regurgitation (n=10). A total of 58 healthy children were considered as normal controls, and a regression equation to predict coaptation depth by body surface area was derived: coaptation depth [mm]=4.37+1.34×ln (body surface area [m2]) (residual standard error, 0.49; adjusted R2, 0.68; p<0.0001). Compared with patients with mild secondary mitral regurgitation, those with moderate or severe secondary mitral regurgitation had significantly larger coaptation depth z-scores (6.4±2.3 versus 1.9±1.4, p<0.005), larger mitral annulus diameter z-scores (3.6±2.6 versus 0.9±1.8, p<0.05), higher left ventricular sphericity index (0.89±0.07 versus 0.79±0.06, p<0.005), and greater left ventricular fraction shortening (0.15±0.05 versus 0.09±0.05, p<0.05). In conclusion, geometric alteration in the mitral valve and the left ventricle is associated with the severity of secondary mitral regurgitation in paediatric dilated cardiomyopathy, which would provide a theoretical background to surgical intervention for secondary mitral regurgitation in paediatric populations.

Relationship of the dimension of cardiac structures to body size: an echocardiographic study in normal infants and children

1999 ◽  
Vol 9 (4) ◽  
pp. 402-410 ◽  
Author(s):  
P. E. F. Daubeney ◽  
E. H. Blackstone ◽  
R. G. Weintraub ◽  
Z. Slavik ◽  
J. Scanlon ◽  
...  
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
The Body ◽  
Infants And Children ◽  
Regression Equations ◽  
Cross Sectional ◽  
Echocardiographic Study ◽  
Z Scores ◽  
Relationship Of

AbstractNormalization of the dimensions of cardiac structures to the size of the body, using so-called Z scores, is becoming increasingly common in the management of infants and children with congenital heart disease. Current published nomograms for the ascertainment of Z scores for cardiac structures in childhood are based largely on normal data obtained in formalin-fixed hearts. Since decisions concerning management are frequently based on the findings of cross-sectional echocardiograms, the dimensions of 15 cardiac structures were measured using cross-sectional echocardiography in 125 normal infants and children. Regression equations were derived relating cardiac dimensions to the size of the body. The expression of size with the highest correlation to cardiac dimensions was body surface area. Nomograms were then developed from which the Z score of a cardiac structure could be estimated from a knowledge of the body surface area and the echocardiographically derived measurement.

scholarly journals Age-adjusted Reference Values and Z-scores of the Coronary Sinus Diameter among Healthy Children and Adolescents in Southern Iran

2021 ◽  
Vol 24 (11) ◽  
pp. 804-810
Author(s):  
Hamid Amoozgar ◽  
Vahid Bazyari ◽  
Mohammadreza Edraki ◽  
Nima Mehdizadegan ◽  
Hamid Mohammadi ◽  
...  
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Coronary Sinus ◽  
Body Surface ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Middle Part ◽  
Z Scores ◽  
The Mean ◽  
The Right

Background: Coronary sinus dimension is an important factor for diagnosing some types of cyanosis as well as congenital heart diseases and insertion of some devices into the coronary sinus if required. This study was designed to access the diameter and Z-score of the coronary sinus among children under 18 years of age. Methods: In this cross-sectional study on 95 individuals, the coronary sinus diameter was measured by transthoracic echocardiography in the four-chamber view at the connection to the right atrium, middle part, and distal end. The linear regression equation was utilized to determine age-adjust reference values, Z-scores, and the relationship between the individuals’ coronary sinus diameter age, height, and body surface area. The study was conducted from March to July 2020 in Namazi hospital clinic of Shiraz University of Medical Sciences, Shiraz, Iran. Results: The mean age of the persons who entered this study was 5.87±4.25 years. The mean coronary sinus diameter was 4.91±1.29 mm at the site of connection to the right atrium, 4.50±1.44 mm at the middle part, and 3.74±1.32 mm at the distal end. Coronary sinus diameter correlates positively with the participants’ age, weight, height, and body surface area (P<0.001). Conclusion: Coronary sinus diameter significantly correlates with the age, height, and body surface area of the cases. These features are useful in diagnosing some congenital heart diseases and insertion of suitable devices through it.

Abstract O.62: Estimation Of The Severity Of Coronary Artery Aneurysm By Z-score Of The Internal Diameter In Kawasaki Disease.

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Naoya Fukushima ◽  
Masaru Miura ◽  
Toru Kobayashi ◽  
Shigeto Fuse ◽  
Tsutomu Saji ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Z Score ◽  
Z Scores ◽  
Coronary Events

Background: The standard values of normal coronary artery internal diameters in Japanese children have been recently established, making it possible to calculate Z-scores based on body surface area. The aim of this study was to clarify the appropriate cut-off points of coronary artery aneurysm (CAA) Z-scores to predict coronary events such as stenosis, obstruction, and thrombosis in patients with Kawasaki disease (KD). Methods: In this multicenter retrospective study, we investigated height, weight, CAA diameters measured by echocardiography in acute phase KD, and coronary events in CAA patients with KD (age 18 years or younger) who had coronary angiography from 1992 to 2011. Results: Interim analysis was performed on data of the 928 patients recruited from 45 institutions. Body surface area (calculated from height and weight) and CAA diameters were available in 702, 680, and 539 cases of right coronary artery (RCA), left main trunk (LMT), left anterior descending artery (LAD), respectively. Coronary events occurred in 62 RCA cases (8.8%), 8 LMT cases (1.2%), and 45 LAD cases (8.3%) . Areas under the ROC curves to predict coronary events were similar for actual diameter, Z-score, and the ratio of actual diameter to that showing a Z-score of zero in each segment. The cut-off points for the actual diameter, Z-score, and ratio which yielding the highest sensitivity plus specificity were 6.3 mm, 9.6, and 3.9 times for RCA; 7.4 mm, 11.1, and 2.8 times for LMT; and 5.3 mm, 8.9, and 3.5 times for LAD. Conclusions: We identified cut-off Z-scores for CAA diameters useful for coronary events prediction. Attention should be paid to coronary events when the Z-score for CAA diameter is over 10.

scholarly journals Relationship of Echocardiographic Z Scores Adjusted for Body Surface Area to Age, Sex, Race, and Ethnicity

2017 ◽  
Vol 10 (11) ◽  
Author(s):  
Leo Lopez ◽  
Steven Colan ◽  
Mario Stylianou ◽  
Suzanne Granger ◽  
Felicia Trachtenberg ◽  
...  
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Race And Ethnicity ◽  
Z Scores ◽  
Relationship Of

scholarly journals Coronary artery diameter measurement and Z-score regression equation calculation: a comparative study between Indian children between one to five years residing in and around Kolkata with children of South-East Asia and Western population

2017 ◽  
Vol 4 (2) ◽  
pp. 403
Author(s):  
Satyaki Das ◽  
Swapan Kumar Ray ◽  
Sukanta Bhattacharya ◽  
Kripasindhu Chatterjee ◽  
Pradyut Kumar Mandal ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
The Body ◽  
Healthy Children ◽  
Z Score ◽  
Z Scores ◽  
Normally Distributed

Background: Congenital coronary anomalies may be isolated, or they may accompany other congenital heart defects, such as Fallot's tetralogy, transposition of the great arteries or pulmonary atresia. The most common cause of acquired abnormalities of the coronary vessels in children is kawasaki disease (KD). The aim of this study was to find the best model to obtain valid and normally distributed Z-scores for coronary artery (CA) diameters in a large, heterogeneous population of healthy children.Methods: Echocardiography was performed on 300 healthy children. Linear regression models were tested with height, weight, body surface area, and aortic valve diameter. The computed Z scores were tested for normal distribution and stability. Results: CA diameter was best predicted using regression with the body surface area and age in month. The weighted least squares method yielded normally distributed and very stable Z-score estimates for 3 principal CAs.Conclusions: This study showed valid methods to estimate Z scores for CA size in children of all ages. Such Z scores are important for risk stratification in patients with Kawasaki disease.

Risk Factors for Bleeding during Treatment of Acute Venous Thromboembolism

1996 ◽  
Vol 76 (05) ◽  
pp. 682-688 ◽  
Author(s):  
Jos P J Wester ◽  
Harold W de Valk ◽  
Karel H Nieuwenhuis ◽  
Catherine B Brouwer ◽  
Yolanda van der Graaf ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Small Body ◽  
Bleeding Risk ◽  
Risk Scores ◽  
Risk Of Bleeding ◽  
Acute Venous Thromboembolism

Summary Objective: Identification of risk factors for bleeding and prospective evaluation of two bleeding risk scores in the treatment of acute venous thromboembolism. Design: Secondary analysis of a prospective, randomized, assessor-blind, multicenter clinical trial. Setting: One university and 2 regional teaching hospitals. Patients: 188 patients treated with heparin or danaparoid for acute venous thromboembolism. Measurements: The presenting clinical features, the doses of the drugs, and the anticoagulant responses were analyzed using univariate and multivariate logistic regression analysis in order to evaluate prognostic factors for bleeding. In addition, the recently developed Utrecht bleeding risk score and Landefeld bleeding risk index were evaluated prospectively. Results: Major bleeding occurred in 4 patients (2.1%) and minor bleeding in 101 patients (53.7%). For all (major and minor combined) bleeding, body surface area ≤2 m2 (odds ratio 2.3, 95% Cl 1.2-4.4; p = 0.01), and malignancy (odds ratio 2.4, 95% Cl 1.1-4.9; p = 0.02) were confirmed to be independent risk factors. An increased treatment-related risk of bleeding was observed in patients treated with high doses of heparin, independent of the concomitant activated partial thromboplastin time ratios. Both bleeding risk scores had low diagnostic value for bleeding in this sample of mainly minor bleeders. Conclusions: A small body surface area and malignancy were associated with a higher frequency of bleeding. The bleeding risk scores merely offer the clinician a general estimation of the risk of bleeding. In patients with a small body surface area or in patients with malignancy, it may be of interest to study whether limited dose reduction of the anticoagulant drug may cause less bleeding without affecting efficacy.

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