Stollery Children's Hospital, Edmonton, Alberta, Canada.
University of Alberta, Edmonton, Alberta, Canada.
Echocardiography. 2024 Oct;41(10):e15929. doi: 10.1111/echo.15929.
Right atrial volume (RAV) and function have proven prognostic value in the assessment of cardiac disease and may be more accurately assessed using three-dimensional echocardiography (3DE). Normal 3DE reference values for the right atrial (RA) volume and function in healthy children have not yet been published. Furthermore, current methods of indexing cardiac measurements to body surface area (BSA) alone may be insufficient. We aimed to develop reference values for 3DE-derived RAV and function in the pediatric population, to provide a comparison of regression methods using BSA, height, weight, and sex, and to compare 3DE values to two-dimensional echocardiography (2DE) derived volumes.
We retrospectively analyzed 187 3DE datasets acquired for a multi-center study on healthy children at two international centers. 3DE volumes were measured with vendor-agnostic software (Tomtec), and 2DE endo-diastolic volume (EDV) using the area-length single-plane approach. Regression curve-fitting of height (Ht), weight (Wt), BSA, and sex were explored to optimize Pearson coefficient and homoscedasticity.
The relationship of 3DE RAVs to BSA alone was heteroscedastic, with a residual positive relationship on indexing (R = 0.2506). Optimal regression of Ln (Volume) = b0 + xLn (Ht) + yLn (Wt) + z*Sex was homoscedastic. Total RA emptying fraction (EF) did not vary across age or sex, however active and passive emptying was best fit by a spline curve with a knot at approximately BSA = 1 m. Strong agreement with 2DE-derived EDV was present (r = 0.83).
We provide reference values for RA size and function in the pediatric population and provide a comparison of methods for indexing these values.
右心房容积（RAV）和功能已被证明在评估心脏疾病方面具有预后价值，并且使用三维超声心动图（3DE）可以更准确地评估。健康儿童的右心房（RA）容积和功能的正常 3DE 参考值尚未公布。此外，仅将心脏测量值指数化到体表面积（BSA）的当前方法可能还不够。我们旨在为儿科人群制定 3DE 衍生的 RAV 和功能的参考值，提供使用 BSA、身高、体重和性别进行回归方法的比较，并将 3DE 值与二维超声心动图（2DE）衍生的容积进行比较。
我们回顾性分析了两个国际中心的一项针对健康儿童的多中心研究中获得的 187 个 3DE 数据集。使用供应商无关的软件（Tomtec）测量 3DE 容积，使用面积长度单平面法测量 2DE 舒张末期容积（EDV）。探索了身高（Ht）、体重（Wt）、BSA 和性别的回归曲线拟合，以优化 Pearson 系数和同方差性。
3DE RAV 与 BSA 单独相关具有同方差性，索引时存在正剩余关系（R = 0.2506）。Ln（体积）= b0 + xLn（Ht）+ yLn（Wt）+ z*性别回归的最佳结果是同方差的。总 RA 排空分数（EF）不因年龄或性别而异，但是主动排空和被动排空通过在 BSA 约为 1 m 处具有结的样条曲线拟合最佳。与 2DE 衍生的 EDV 具有很强的一致性（r = 0.83）。
我们提供了儿科人群中 RA 大小和功能的参考值，并对这些值的索引方法进行了比较。
