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570名健康儿童及52名小儿房间隔缺损患者右心室流出道速度时间积分测定

Right Ventricular Outflow Tract Velocity Time Integral Determination in 570 Healthy Children and in 52 Pediatric Atrial Septal Defect Patients.

作者信息

Koestenberger Martin, Nage Bert, Ravekes William, Avian Alexander, Burmas Ante, Grangl Gernot, Cvirn Gerhard, Gamillscheg Andreas

机构信息

Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria,

出版信息

Pediatr Cardiol. 2015 Aug;36(6):1129-34. doi: 10.1007/s00246-015-1131-7. Epub 2015 Mar 6.

Abstract

Determination of the right ventricular outflow tract velocity time integral (RVOT VTI) is an important part of the noninvasive investigation of pulmonary blood flow in adults; however, age-related pediatric reference data are lacking. We examined growth-related changes of RVOT VTI values in children and the predictive value of RVOT VTI values in identifying enhanced pulmonary blood flow in children with secundum type atrial septal defect (ASD). A prospective study was conducted in a group of 570 healthy children and 52 children with a moderate-sized to large ASD. We determined the effects of age, body length (BL), body weight (BW), and body surface area (BSA) on RVOT VTI values. The predictive value of normal values stratified for age, BW, BL, and BSA was tested in our 52 ASD children. RVOT VTI values ranged from mean 9.7 ± 1.2 cm in neonates to 23.3 ± 2.7 cm in children with 18 years of age and showed a positive correlation with age, BL, BSA, and BW. In our population, RVOT VTI z-scores showed a high specificity for detecting ASD patients (>97 %) with sensitivity up to 71 %. We provide normal ranges and calculated z-scores of pediatric RVOT VTI values. Normal RVOT VTI z-scores might be additional predictors in identifying increased pulmonary blood flow in patients with ASD.

摘要

测定右心室流出道速度时间积分(RVOT VTI)是成人肺血流无创检查的重要组成部分;然而,缺乏与年龄相关的儿科参考数据。我们研究了儿童RVOT VTI值与生长相关的变化,以及RVOT VTI值在识别继发孔型房间隔缺损(ASD)患儿肺血流增加方面的预测价值。对570名健康儿童和52名中大型ASD患儿进行了一项前瞻性研究。我们确定了年龄、身长(BL)、体重(BW)和体表面积(BSA)对RVOT VTI值的影响。在我们的52名ASD患儿中测试了按年龄、BW、BL和BSA分层的正常值的预测价值。RVOT VTI值范围从新生儿的平均9.7±1.2厘米到18岁儿童的23.3±2.7厘米,并与年龄、BL、BSA和BW呈正相关。在我们的研究人群中,RVOT VTI z评分对检测ASD患者具有高特异性(>97%),敏感性高达71%。我们提供了儿科RVOT VTI值的正常范围和计算出的z评分。正常的RVOT VTI z评分可能是识别ASD患者肺血流增加的额外预测指标。

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