Age-related variation in contractility estimate in patients ≤20 years of age

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      The relation between velocity of circumferential fiber shortening (VCF) and wall stress (WS) is being used to estimate contractile state in a variety of disease states and patient ages more frequently. However, its relation to age has not been established. To determine reproducibility and age and sex dependence of this relation, 204 normal children (113 boys, 91 girls) underwent echographic determination of VCF and WS. The children were enrolled in 3 groups: group 1 < 6 months old (n = 27); group 2 >6 months and <3 years old (n = 38); and group 3 >3 and <20 years old (n = 139). Twenty-five children also underwent serial echocardiography (n = 44) to determine reproducibility of the relation. Only 1 of the 44 repeat data pairs of VCF and WS was outside the 95% confidence limits of that relation. In all 3 groups, VCF was significantly inversely and linearly related to WS (p < 0.001). The regression equation in the oldest group was very similar to previous reports (VCF = −0.0031 [WS] + 1.21). The regression lines in the 2 younger groups were significantly steeper and had a significantly higher y-intercept (p < 0.01). Group 1 had the steepest slope and highest y-intercept. There was no difference in the regression lines of different sexes in any of the patient groups. It is concluded that the relation of VCF to WS is reproducible over time. It is age-dependent but has no relation to gender. VCF in patients <6 months old is more highly dependent on WS. Clinician and investigators need to select the appropriate age-related relation to study contractility in young patients.
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