Webb Rachel H, Culliford-Semmens Nicola, Sidhu Karishma, Wilson Nigel J
Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand; Paediatric Infectious Diseases, Starship Children's Hospital, Auckland, New Zealand.
Green Lane Paediatric and Congenital Cardiac Services , Starship Children's Hospital , Auckland , New Zealand.
Heart Asia. 2017 Mar 21;9(1):70-75. doi: 10.1136/heartasia-2016-010872. eCollection 2017.
We aimed to define the normal range of aortic and mitral valve thickness in healthy schoolchildren from a high prevalence rheumatic heart disease (RHD) region, using a standardised protocol for imaging and measurement.
Measurements were performed in 288 children without RHD. Anterior mitral valve leaflet (AMVL) thickness measurements were performed at the midpoint and tip of the leaflet in the parasternal long axis (PSLA) in diastole, when the AMVL was approximately parallel to the ventricular septum. Thickness of the aortic valve was measured from PSLA imaging in systole when the leaflets were at maximum excursion. The right coronary and non-coronary closure lines of the aortic valve were measured in diastole in parasternal short axis (PSSA) imaging. Results were compared with 51 children with RHD classified by World Heart Federation diagnostic criteria.
In normal children, median AMVL tip thickness was 2.0 mm (IQR 1.7-2.4) and median AMVL midpoint thickness 2.0 mm (IQR 1.7-2.4). The median aortic valve thickness was 1.5 mm (IQR 1.3-1.6) in the PSLA view and 1.4 mm (IQR 1.2-1.6) in the PSSA view. The interclass correlation coefficient for the AMVL tip was 0.85 (0.71 to 0.92) and for the AMVL midpoint was 0.77 (0.54 to 0.87).
We have described a standardised method for mitral and aortic valve measurement in children which is objective and reproducible. Normal ranges of left heart valve thickness in a high prevalence RHD population are established. These results provide a reference range for school-age children in high prevalence RHD regions undergoing echocardiographic screening.
我们旨在使用标准化的成像和测量方案，确定来自风湿性心脏病（RHD）高流行地区的健康学龄儿童主动脉瓣和二尖瓣厚度的正常范围。
对288名无RHD的儿童进行测量。舒张期，在胸骨旁长轴（PSLA）切面，当二尖瓣前叶（AMVL）大致与室间隔平行时，在瓣叶中点和尖端测量AMVL厚度。收缩期，当主动脉瓣叶处于最大活动度时，从PSLA成像测量主动脉瓣厚度。在胸骨旁短轴（PSSA）成像的舒张期测量主动脉瓣的右冠状动脉和无冠状动脉闭合线。将结果与51名根据世界心脏联合会诊断标准分类的RHD儿童进行比较。
在正常儿童中，AMVL尖端厚度中位数为2.0 mm（四分位间距1.7 - 2.4），AMVL中点厚度中位数为2.0 mm（四分位间距1.7 - 2.4）。在PSLA视图中，主动脉瓣厚度中位数为1.5 mm（四分位间距1.3 - 1.6），在PSSA视图中为1.4 mm（四分位间距1.2 - 1.6）。AMVL尖端的组内相关系数为0.85（0.71至0.92），AMVL中点为0.77（0.54至0.87）。
我们描述了一种用于儿童二尖瓣和主动脉瓣测量的标准化方法，该方法客观且可重复。确定了RHD高流行人群左心瓣膜厚度的正常范围。这些结果为RHD高流行地区接受超声心动图筛查的学龄儿童提供了参考范围。
