Vogel M, Smallhorn J F, Stein J I, Freedom R M
Department of Pediatrics, University of Toronto, Faculty of Medicine, Ontario, Canada.
J Am Coll Cardiol. 1990 May;15(6):1409-16. doi: 10.1016/s0735-1097(10)80032-4.
Because comprehensive normal data and the effect of observer variability for echocardiographic evaluation of regional left ventricular wall motion are not available in children or newborns, left ventricular wall motion was assessed by measuring regional area change. The study group comprised 55 infants and children with a normal heart: 15 neonates (greater than 1 week to less than 1 month old), 10 infants (greater than 1 month to less than 1 year old) and 30 children, 10 each in the age group greater than 1 year to less than 5 years, greater than 5 to less than or equal to 10 years and greater than 10 years. A combination of parasternal, apical and subcostal two-dimensional echocardiographic views was applied. After planimetry of an end-systolic and end-diastolic frame, the left ventricle was divided into eight equal segments and the percent area change calculated. Both a fixed reference and a floating system correcting for translation and rotation were applied. Intraobserver variability for percent area change measurements was 2.8 +/- 0.9% and 3.8 +/- 1% for observers 1 and 2, respectively. The mean interobserver difference of regional percent area change was 4.7 +/- 1.8%. Normal values for the eight anatomic segments were established in each echocardiographic imaging plane. The overall results were independent of the type of reference system utilized. The subcostal views yielded different results from their parasternal counterparts, probably because of differing imaging planes. These normal values establish a data base in the pediatric age range that can be used to detect abnormal segments in children at risk for developing regional left ventricular wall motion abnormalities.
由于儿童或新生儿缺乏用于评估左心室壁节段运动的超声心动图的全面正常数据以及观察者变异性的影响，因此通过测量节段面积变化来评估左心室壁运动。研究组包括55名心脏正常的婴儿和儿童：15名新生儿（大于1周龄至小于1月龄），10名婴儿（大于1月龄至小于1岁）和30名儿童，年龄组分别为大于1岁至小于5岁、大于5岁至小于或等于10岁以及大于10岁，各10名。应用了胸骨旁、心尖和肋下二维超声心动图视图的组合。在对收缩末期和舒张末期图像进行面积测量后，将左心室分为8个相等的节段并计算面积变化百分比。同时应用了固定参考系统和校正平移和旋转的浮动系统。观察者1和观察者2测量面积变化百分比的观察者内变异性分别为2.8±0.9%和3.8±1%。观察者间节段面积变化百分比的平均差异为4.7±1.8%。在每个超声心动图成像平面中确定了8个解剖节段的正常值。总体结果与所使用的参考系统类型无关。肋下视图与胸骨旁视图的结果不同，可能是因为成像平面不同。这些正常值在儿童年龄范围内建立了一个数据库，可用于检测有发生左心室壁节段运动异常风险的儿童中的异常节段。
