Estudio de volúmenes de ventrículo izquierdo mediante ecocardiografía 4D en edad pediátrica

Abstract

4D echocardiography (4D-Echo) has become a significant advance in the field of cardiac imaging, being a competitive option in pediatric patients. Left ventricle (LV) evaluation is essential for diagnosis, treatment, and prognostic of congenital heart disease. However, there are few studies carried out in this cohort and standardized normality values are lacked. The main objective of this study was to establish normal LV values in pediatric patients using 4D-Echo and comparing them to the LV volumes obtained using 2D-Echo (manual and automatic), M-mode and cardiac magnetic resonance (CMR). Observational, analytical, and cross-sectional study carried out in a tertiary children's cardiology hospital from November 2021 to May 2022. We included patients with a normal LV and weight less than 40 kg. Demographic, electrocardiographic and echocardiographic (M mode, 2D and 4D) data were collected. CMR publishing data were also included. Echocardiography was carried out using E95 and the new probe 6Vc-D. 132 patients were included but only 103 patients were totally analyzed. 60. 2% of patients were male. Mean aged was 5. 123. 74 years, being 31% under 2 years. Mean heart rate was 101. 39 bpm and mean blood pressure was 101/62 mmHg. 97% had sinus rhythm. Normality values corrected by age and body surface area (by Haycock' formula) were established. Lambda-Mu-Sigma percentiles curves were generated. Statistically significant correlation (p<0. 001) was observed between LV volume measurements in 4D-Echo and 2D-Echo (manual and automatic). However, statistically significant differences were observed between 4D-Echo and manual 2D-Echo. 4D-Echo volume data were larger than 2D-Echo, similar to those publishing by CMR. Moderated correlation was observed between ejection fraction measurements by 4D-Echo and 2D-Echo, but not statistically differences were found. No correlation was found to M-mode. In conclusion, normal LV values have been obtained by 4D-Echo. Larger volumes have been observed with 4D-echo, although there is a good correlation between 4D-Echo and other techniques. The establishment of these values could be useful in the assessment of pediatric patients, due to the reproducibility and accessibility of this technique.

Date of Award	23 Jul 2025
Original language	Spanish
Supervisor	Ferran Roses Noguer (Director) & Anna Sabate Rotes (Director)