Xiang Xue, Zhu Xu, Zheng Min, Tang Yi
Department of Ultrasound, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Front Pediatr. 2023 Sep 4;11:1206314. doi: 10.3389/fped.2023.1206314. eCollection 2023.
To investigate the consistency between the 2016 America Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) guideline-based recommendations and the body surface area (BSA)-transformed value-based cut-off for the assessment of left ventricular diastolic function (LVDF) in children.
Clinical data of children with heart failure (HF) and those with a high risk of HF and a low risk of HF were collected from the Children's Hospital of Chongqing Medical University between March 2021 and October 2022. The mitral annular ' velocity, lateral /' ratio, left atrial volume index, and peak tricuspid regurgitation velocity were detected by Echocardiography. The cut-off values recommended by the 2016 ASE/EACVI guidelines and the cut-off value based on the BSA-transformed value were used to evaluate LVDF. The consistencies and differences of the two criteria were compared.
A total of 132 children with HF, 189 with a high risk of HF, and 231 with a low risk of HF, were enrolled. The consistency of the two criteria in evaluating LVDF in children with HF and with high risk of HF was moderate, with weighted kappa coefficients of 0.566 and 0.468, respectively ( < 0.001). The positivity rate of left ventricular diastolic dysfunction (LVDD) with value-based criteria (HF group, 23.5%; high-risk group, 8.5%) was higher than that with guideline-based criteria (HF group, 15.6%; high-risk group, 3.2%). In children with a low risk of HF, no case with LVDD was found. The consistency between the two criteria for grading the degree of LVDD was moderate, with a kappa coefficient of 0.522 ( = 0.001). The degree of LVDD according to the value-based criteria was higher than that of the guideline-based criteria ( = 0.004).
The value-based criteria used to evaluate LVDD in children with HF and high risk of HF may be more conducive to the early identification of LVDD, thereby permitting the possibility of early treatment intervention.
探讨基于2016年美国超声心动图学会（ASE）/欧洲心血管影像协会（EACVI）指南的建议与基于体表面积（BSA）转换的左心室舒张功能（LVDF）评估值截断值之间的一致性。
收集2021年3月至2022年10月重庆医科大学附属儿童医院心力衰竭（HF）患儿、HF高危患儿和HF低危患儿的临床资料。通过超声心动图检测二尖瓣环速度、侧壁/比值、左心房容积指数和三尖瓣反流峰值速度。采用2016年ASE/EACVI指南推荐的截断值和基于BSA转换值的截断值评估LVDF。比较两种标准的一致性和差异。
共纳入132例HF患儿、189例HF高危患儿和231例HF低危患儿。两种标准在评估HF患儿和HF高危患儿LVDF方面的一致性为中等，加权kappa系数分别为0.566和0.468（P<0.001）。基于值标准的左心室舒张功能障碍（LVDD）阳性率（HF组为23.5%；高危组为8.5%）高于基于指南标准的阳性率（HF组为15.6%；高危组为3.2%）。在HF低危患儿中，未发现LVDD病例。两种标准在LVDD程度分级上的一致性为中等，kappa系数为0.522（P=0.001）。基于值标准的LVDD程度高于基于指南标准的程度（P=0.004）。
用于评估HF患儿和HF高危患儿LVDD的基于值标准可能更有助于LVDD的早期识别，从而为早期治疗干预提供可能。
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