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Assessment of left ventricular mass and volume by cross-sectional echocardiography in newborns and infants with tricuspid atresia prior to surgical intervention

Published online by Cambridge University Press:  19 August 2008

Michael Vogel ,
Jan Skovaranek  and
Konrad Bühlmeyer
Michael Vogel*
Affiliation:
From the Klinik für Herz-und Kreislaufkrankheiten im Kindesalter am Deutschen Herzzentrum München, Praha
Jan Skovaranek
Affiliation:
München, and the Kardiocentrum Motol, Praha
Konrad Bühlmeyer
Affiliation:
From the Klinik für Herz-und Kreislaufkrankheiten im Kindesalter am Deutschen Herzzentrum München, Praha
*
Priv.-Doz. Dr. Michael Vogel, Kinderkardiologieam Deutschen Herzzentrum Munchen, Lothstr. 11, 8000 Munchen 2, Federal Republic of Germany. Tel. 49 89 1209 450; Fax. 49 89 1209 549.
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Summary

Because left ventricular mass may be important in judging feasibility of Fontan type of palliation in tricuspid atresia, this study was undertaken to generate data on left ventricular mass, volume and mass to volume ratio in newborns and infants with tricuspid atresia, native pulmonary stenosis and concordant ventriculoarterial connections prior to any surgical palliation to obtain values for “normal” left ventricular dimensions in tricuspid atresia. The left ventricle was evaluated in the apical two and four chamber view. From these two perpendicular imaging planes, we calculated mass as difference between epicardial and endocardial volume x 1.05 (specific gravity of heart muscle). Mass divided by volume at end-diastole yields the index: mass to volume. Data from 23 newborns and infants with tricuspid atresia were compared to data from 30 age-matched controls with normal hearts. In both patient and control groups, growth of the left ventricle was not linear but related to the 1.4 (volume) or 1.25 (mass) power of body surface area. The equation best describing relation between left ventricular volume and body surface area in normals is volume = 60.7(body surface area)1.4−0.2 ml; in patients with tricuspid atresia volume calculates as 96.7(body surface area)1.4+0.9 ml. In relation to normal infants, infants with tricuspid atresia had a left ventricular volume of 167 (135–206)% of normal and a left ventricular mass of 163 (132–201)% of normal. Left ventricular mass assessed in normals calculates as mass = 59.9(body surface area)1.25+1.3 grams; in patients with tricuspid atresia it calculates as mass= 117.5 (body surface area)1.25−0.9 grams. The index of left ventricular mass to volume in patients with tricuspid atresia measured 1.32, not significantly different from controls, in whom this index calculates as 1.34.

Keywords

Cross-sectional echocardiographytricuspid atresialeft ventricular myocardial massleft ventricular volume
Type
Original Articles
Information
Cardiology in the Young , Volume 3 , Issue 1 , January 1993 , pp. 34 - 38
Copyright
Copyright © Cambridge University Press 1993

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References

1.Kirklin, JK, Blackstone, EH, Kirklin, JW, Pacifico, AD, Bargeron, LM. The Fontan operation.Ventricular hypertrophy, age and date of operation as risk factors. J Thorac Cardiovasc Surg 1986; 92: 1049–1063.Google Scholar
2.Seliem, M, Muster, A, Paul, M, Benson, W Jr. Relation between preoperative left ventricular muscle mass and outcome of the Fontan procedure in patients with tricuspid atresia. J Am Coll Cardiol 1989; 14: 750–755.CrossRefGoogle ScholarPubMed
3.Dougherty, AH, Naccarelli, GV, Gray, EL, Hicks, CH, Goldstein, RA. Congestive heart failure with normal systolic function. Am J Cardiol 1984; 54: 778–782.CrossRefGoogle ScholarPubMed
4.Nishioka, K, Kamiya, T, Ueda, T, Hayashidera, T, Mori, C, Konishi, Y, Tatsuta, N, Jarmakani, JM. Left ventricular volume characteristics in children with tricuspid atresia before and after surgery. Am J Cardiol 1981; 47: 1105–1110.Google Scholar
5.Schiller, NB, Acquatella, H, Ports, TA, Drew, D, Goerke, J, Ringertz, H, Silverman, NH, Brundage, B, Botvinick, EH, Boswell, R, Carlson, E, Parmley, WW. Left ventricular volume from paired biplane two-dimensional echocardiography. Circulation 1979; 60: 547–555.CrossRefGoogle ScholarPubMed
6.Silverman, NH, Ports, TA, Snider, RA, Schiller, NB, Carlsson, E, Heilbron, DC. Determination of left ventricular volume in children: echocardiographic and angiographic comparisons. Circulation 1980; 62: 548–557.CrossRefGoogle ScholarPubMed
7.Rackley, CE, Dodge, HT, Coble, YD Jr, Hay, RE. A method for determining left ventricular mass in man. Circulation 1964; 29: 666–671.CrossRefGoogle ScholarPubMed
8.Onnasch, DGW, Lange, PE, Heintzen, PH. Left ventricular muscle volume in children and young adults. Pediatr Cardiol 1984; 5: 101–106.Google Scholar
9.Vogel, M, Staller, W, Biihlmeyer, K.Left ventricular myocardial mass determined by cross-sectional echocardiography in normal newborns, infants, and children. Pediatr Cardiol 1991; 12: 143–149.CrossRefGoogle ScholarPubMed
10.Edwards, JE, Burchell, HB. Congenital tricuspid atresia: a classification. Med Clin North Am 1949; 33: 1177–1195.CrossRefGoogle ScholarPubMed
11.Sauer, U, Mocellin, R.Angiocardiographic left ventricular volume determination in tricuspid atresia. Herz 1979; 4: 248–255.Google ScholarPubMed
12.Graham, TP, Franklin, RCG, Wyse, RKH, Gooch, W, Deanfield, JE.Left ventricular wall stress and contractile function in childhood: normal values and comparison of Fontan repair versus palliation only in patients with tricuspid atresia. Circulation 1986; 74 (Suppl I): I 61–1 69.Google Scholar
13.Daniels, SR, Meyer, RA, Liang, Y, Bove, KE.Echocardio-graphically determined left ventricular mass index in normal children, adolescents and adults. J Am Coll Cardiol 1988; 12: 703–708.CrossRefGoogle Scholar
14.Collins, HW, Kronenberg, MW, Byrd, BF III. Reproducibility of left ventricular mass measurements by two-dimensional and M-mode echocardiography. J Am Coll Cardiol 1989; 14: 672–676.CrossRefGoogle ScholarPubMed
15.Bachenberg, TC, Shub, C, Hauck, AJ, Edwards, WD.Can anatomical left ventricular mass be estimated reliably by M-mode echocardiography? A clinicopathological study of 93 patients. Echocardiography 1991; 8: 9–15.CrossRefGoogle Scholar
16.Vogel, M, Stern, H, Bauer, R, Biihlmeyer, K.Comparison of magnetic resonance imaging with cross sectional echocardiography in the assessment of left ventricular mass in children without heart disease and in aortic isthmic coarctation. Am J Cardiol 1992; 69: 941–944.Google Scholar
17.Choussat, A, Fontan, F, Reese, P, Vallot, F, Chauve, A, Bricand, A. Selection criteria for Fontan's procedure. In: Anderson, RH, Shinebourne, EA (eds). Pediatric Cardiology 1977. Churchill Livingstone, Edinburgh, 1978, pp 559–566.Google Scholar
18.Mair, DD, Hagler, DJ, Puga, FJ, Schaff, HV, Danielson, GK.Fontan operation in 176 patients with tricuspid atresia. Results and a proposed new index for patient selection. Circulation 1990; 82 (Suppl IV): IV 164–IV 169.Google Scholar
19.Plehn, JF, Lotvin, A, Apstein, CS.Life-threatening pulmonary edema due to left ventricular diastolic dysfunction. Circulation 1987; 76 (Supp IV): IV 411. [Abstract]Google Scholar
20.Gaasch, WH.Left ventricular radius to wall thickness ratio. Am J Cardiol 1979; 43: 1189–1194.CrossRefGoogle ScholarPubMed
21.Perloff, JK.Development and regression of increased ventricular mass. Am J Cardiol 1982; 50: 605–611.Google Scholar