Derivation of Transthoracic Echocardiographic Reference Ranges for Left Ventricular, Left Atrial and Aortic Root M-Mode Dimensions in Preterm Infants

2012 ◽  
Vol 21 ◽  
pp. S291-S292
Author(s):  
S. Farrell ◽  
S. Hope
Keyword(s):  
Preterm Infants ◽  
Aortic Root ◽  
Left Atrial ◽  
Left Ventricular ◽  
Reference Ranges

scholarly journals Oxygen saturation and heart rate in healthy term and late preterm infants with delayed cord clamping

2022 ◽  
Author(s):  
Inmaculada Lara-Cantón ◽  
Shiraz Badurdeen ◽  
Janneke Dekker ◽  
Peter Davis ◽  
Calum Roberts ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Preterm Infants ◽  
Left Ventricular ◽  
Late Preterm ◽  
Arterial Oxygen ◽  
Reference Ranges ◽  
Delayed Cord Clamping ◽  
Late Preterm Infants ◽  
Cord Clamping ◽  
Neonatal Transition

Abstract Blood oxygen in the fetus is substantially lower than in the newborn infant. In the minutes after birth, arterial oxygen saturation rises from around 50–60% to 90–95%. Initial respiratory efforts generate negative trans-thoracic pressures that drive liquid from the airways into the lung interstitium facilitating lung aeration, blood oxygenation, and pulmonary artery vasodilatation. Consequently, intra- (foramen ovale) and extra-cardiac (ductus arteriosus) shunting changes and the sequential circulation switches to a parallel pulmonary and systemic circulation. Delaying cord clamping preserves blood flow through the ascending vena cava, thus increasing right and left ventricular preload. Recently published reference ranges have suggested that delayed cord clamping positively influenced the fetal-to-neonatal transition. Oxygen saturation in babies with delayed cord clamping plateaus significantly earlier to values of 85–90% than in babies with immediate cord clamping. Delayed cord clamping may also contribute to fewer episodes of brady-or-tachycardia in the first minutes after birth, but data from randomized trials are awaited. Impact Delaying cord clamping during fetal to neonatal transition contributes to a significantly earlier plateauing of oxygen saturation and fewer episodes of brady-and/or-tachycardia in the first minutes after birth. We provide updated information regarding the changes in SpO2 and HR during postnatal adaptation of term and late preterm infants receiving delayed compared with immediate cord clamping. Nomograms in newborn infants with delayed cord clamping will provide valuable reference ranges to establish target SpO2 and HR in the first minutes after birth.

scholarly journals Aortic Root Remodeling as an Indicator for Diastolic Dysfunction and Normative Ranges in Asians: Comparison and Validation with Multidetector Computed Tomography

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 712
Author(s):  
Lawrence Yu-min Liu ◽  
Chun-Ho Yun ◽  
Jen-Yuan Kuo ◽  
Yau-Huei Lai ◽  
Kuo-Tzu Sung ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diastolic Dysfunction ◽  
Multidetector Computed Tomography ◽  
Aortic Root ◽  
Asian Population ◽  
Population Based ◽  
Root Diameter ◽  
Left Ventricular ◽  
Aortic Diameter ◽  
Reference Ranges

Background: The aortic root diameter (AoD) has been shown to be a marker of cardiovascular risk and heart failure (HF). Data regarding the normal reference ranges in Asians and their correlates with diastolic dysfunction using contemporary guidelines remain largely unexplored. Methods: Among 5343 consecutive population-based asymptomatic Asians with echocardiography evaluations for aortic root diameter (without/with indexing, presented as AoD/AoDi) were related to cardiac structure/function and N-terminal pro-brain B-type natriuretic peptide (Nt-ProBNP), with 245 participants compared with multidetector computed tomography (MDCT)-based aortic root geometry. Results: Advanced age, hypertension, higher diastolic blood pressure, and lower body fat all contributed to greater AoD/AoDi. The highest correlation between echo-based aortic diameter and the MDCT-derived measures was found at the level of the aortic sinuses of Valsalva (r = 0.80, p < 0.001). Age- and sex-stratified normative ranges of AoD/AoDi were provided in 3646 healthy participants. Multivariate linear regressions showed that AoDi was associated with a higher NT-proBNP, more unfavorable left ventricular (LV) remodeling, worsened LV systolic annular velocity (TDI-s′), a higher probability of presenting with LV hypertrophy, and abnormal LV diastolic indices except tricuspid regurgitation velocity by contemporary diastolic dysfunction (DD) criteria (all p < 0.05). AoDi superimposed on key clinical variables significantly expanded C-statistic from 0.71 to 0.84 (p for ∆AUROC: < 0.001). These associations were broadly weaker for AoD. Conclusion: In our large asymptomatic Asian population, echocardiography-defined aortic root dilation was associated with aging and hypertension and were correlated modestly with computed tomography measures. A larger indexed aortic diameter appeared to be a useful indicator in identifying baseline abnormal diastolic dysfunction.

scholarly journals Increased Mobility of the Atrial Septum in Aortic Root Dilation: An Observational Study on Transesophageal Echocardiography

2021 ◽  
Vol 12 ◽  
Author(s):  
Altair Heidemann ◽  
Lorença Dall'Oglio ◽  
Eduardo Gehling Bertoldi ◽  
Murilo Foppa
Keyword(s):  
Ejection Fraction ◽  
Aortic Root ◽  
Left Atrial ◽  
Root Diameter ◽  
Left Ventricular ◽  
Atrial Septum ◽  
Root Anatomy ◽  
Left Ventricular Ejection ◽  
Atrial Septal Aneurysm ◽  
Ventricular Ejection Fraction

Background: There is a growing interest in the relationship between atrial septal anatomy and cardioembolic stroke. Anecdotal reports suggest that the enlargement of the aortic root could interfere with atrial septal mobility (ASM). We sought to investigate the association between ASM and aortic root dilation.Methods and Findings: From all consecutive clinically requested transesophageal echocardiogram (TEE) studies performed during the study period in a single institution, we were able to review and evaluate the ASM and anteroposterior length, aortic root diameter, and the prevalence of atrial septal aneurysm (ASA) and of patent foramen ovale (PFO) in 336 studies. Additional variables, such as left ventricular ejection fraction, left atrial diameter, diastolic dysfunction, age, sex, weight, height, previous stroke, atrial fibrillation, and TEE indication, were extracted from patient medical records and echocardiographic clinical reports. In 336 patients, we found a mean ASM of 3.4 mm, ranging from 0 to 21 mm; 15% had ASA and 14% had PFO. There was a 1.0 mm increase in ASM for every 10-mm increase in aortic root diameter adjusted for age, sex, weight, height, ejection fraction, and left atrial size (B = 0.1; P = 0.04). Aortic diameter was not associated with a smaller septal length (B = 0.03; P = 0.7).Conclusion: An increased motion of the atrial septum can occur in association with aortic dilation. These findings deserve attention for the relevance of aortic root anatomy in future studies involving atrial septal characteristics and embolic stroke risk.

scholarly journals Normal reference ranges for left ventricular dimensions in preterm infants

2014 ◽  
Vol 7 (3) ◽  
pp. 180 ◽  
Author(s):  
Lulu Abushaban ◽  
MariappaThinakar Vel ◽  
Jebaraj Rathinasamy ◽  
PremN Sharma
Keyword(s):  
Preterm Infants ◽  
Left Ventricular ◽  
Reference Ranges ◽  
Normal Reference ◽  
Left Ventricular Dimensions ◽  
Ventricular Dimensions

scholarly journals Normal values for indexed left atrial end-systolic volume by two- and three-dimensional echocardiography. A cross-sectional population study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
T Eriksen-Volnes ◽  
B Nes ◽  
U Wislof ◽  
L Lovstakken ◽  
H Dalen
Keyword(s):  
Left Atrium ◽  
Left Atrial ◽  
Normal Values ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Volume Index ◽  
Reference Ranges ◽  
Systolic Volume ◽  
End Systolic Volume ◽  
2D And 3D

Abstract Background The left atrium volume and function gives important prognostic and diagnostic information. Normal values for left atrial end-systolic volume index (LASVI) is derived from 4-chamber and 2-chamber views or three-dimensional (3D) imaging. In current recommendations LASVI above 34 ml/m2 has been regarded dilated when assessing diastolic function and left ventricular filling pressures. It is not known if improved image quality by new scanners or more dedicated atrial focused views provide the same normal reference ranges. Material and methods We examined a large sub-population participating in a population based health study by high-end echocardiographic scanners. LA volume was assessed at end-systole in two-dimensional (2D) recordings focusing on the left atrium to avoid foreshortening. Additionally, 3D full volume recordings were acquired stitching 2–4 cardiac cycles when feasible using breath hold. All echocardiograms were analyzed offline using dedicated commercial software with manual tracing of the endocardial border and calculation of volume by the summation of discs method in 2D recordings. Results 2462 of 5763 invited persons was examined by echocardiography. 1048 persons were excluded due to known heart disease, atrial fibrillation, antihypertensive treatment, diabetes mellitus or findings of clear pathology on echocardiography leaving 1414 persons presumed free of cardiovascular disease or major risk factors for the analyses. Mean ± SD age was 57.9±12.4, and 55.8% was females. Mean (SD) LASVI in females and males were 27.6±9.7 ml/m2 and 30.7±11.1 ml/m2 by 2D imaging, respectively. Similarly, mean ± SD LASVI in females and males were 29.1±6.8 ml/m2 and 30.5±7.9 ml/m2 by 3D. The distribution of LASVI by age is showed in figure 1. The mean ± SD difference between 2D and 3D intra-individual measurements were 0.31±9.0 ml/m2 corresponding to 1.1%. By 2D assessment 24.1% of this presumed healthy cohort had a LASVI over 34 ml/m2, with more males than females had enlarged left atria by this definition (32.7% vs 20.1%, p&lt;0.001). Conclusion New reference ranges for left atrial size is provided for 2D and 3D recordings. By dedicated 2D recordings normal values are larger than previously recorded, and the difference between 2D and 3D recordings are less than previously reported. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): NTNU and the HUNT study Figure 1. Indexed left atrial end-systolic volume, summation of discs method using adjusted left atrial view vs age. The red line denotes 34 ml/m2 used as the cut-off value in present guidelines.

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