Advertisement

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

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      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.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Kimball TR
        • Daniels SR
        • Weiss RG
        • Meyer RA
        • Hannon DW
        • Ryckman FC
        • Tian J
        • Shukla R
        • Schwartz DC
        Changes in cardiac function during extracorporeal membrane oxygenation for persistent pulmonary hypertension in the newborn.
        J Pediatr. 1991; 118: 431-436
        • Newburger JW
        • Sanders SP
        • Burns JL
        • Parness IA
        • Beiser AS
        • Colan SD
        Left ventricular contractility and function in Kawasaki syndrome: effect of intravenous gammagobulin.
        Circulation. 1989; 79: 1237-1246
        • Feldman T
        • Borow KM
        • Same KH
        • Neumann A
        • Lang RM
        Myocardial mechanics in hyperthyroidism: importance of left ventricular loading conditions, heart rate, and contractile state.
        J Am Coll Cardiol. 1986; 7: 967-974
        • Colan SD
        • Trowitzsch E
        • Wernovsky G
        • Sholler GF
        • Sanders SP
        • Castaneda AR
        Myocardial performance after arterial switch operation for transposition of the great arteries with intact septum.
        Circulation. 1988; 78: 132-141
        • Colan SD
        • Borow KM
        • Neumann A
        Left ventricular end-systolic wall stressvelocity of fiber shortening relation: a load-independent index of myocardial contractility.
        J Am Coll Cardiol. 1984; 4: 715-724
        • Romero TE
        • Friedman WF
        Limited left ventricular response to volume over-load in the neonatal period.
        Pediatr Res. 1979; 13: 910-915
        • Riemenschneider TA
        • Brenner RA
        • Mason DT
        Maturational changes in myocardial contractile state of newborn lambs.
        Pediatr Res. 1981; 15: 349-356
        • Berman W
        • Musselman J
        Myocardial performance in the newborn lamb.
        Am J Physiol. 1979; 6: H66-H70
        • Klopfenstein HS
        • Rudolph AM
        Postnatal changes in the circulation and response to volume loading in sheep.
        Circ Res. 1978; 42: 839-845
        • Bazett HC
        An analysis of the time relations of electrocardiograms.
        Heart. 1920; 7: 353-370
        • Grossman W
        • Jones W
        • McLaurin LP
        Wall stress and patterns of hypertrophy in the human left ventricle.
        J Clin Invest. 1975; 56: 56-64
        • Lang RM
        • Borow KM
        • Neumann A
        • Janzen D
        Systemic vascular resistance: an unreliable index of left ventricular afterload.
        Circulation. 1986; 74: 1114-1123
        • Devereux RB
        • Alonso DR
        • Lutas EM
        • Gottlieb GJ
        • Campo E
        • Sachs I
        • Reicheck N
        Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings.
        Am J Cardiol. 1986; 57: 450-458
        • Kimball TR
        • Daniels SR
        • Meyer RA
        • Hannon DW
        • Tian J
        • Shukla R
        • Schwartz DC
        Effect of digoxin on contractility and symptoms in infants with a large ventricular septal defect.
        Am J Cardiol. 1991; 68: 1377-1382
        • Franklin RCG
        • Wyse RKH
        • Graham TP
        • Gooch VM
        • Deanfield JE
        Normal values for noninvasive estimation of left ventricular contractile state and afterload in children.
        Am J Cardiol. 1990; 65: 505-510
        • Friedman WF
        The intrinsic physiologic properties of the developing heart.
        Prog Cardiovasc Dis. 1972; 15: 87-111
        • Van Hare GE
        • Hawkins J
        • Schmidt KG
        • Rudolph AM
        The effects of increasing mean arterial pressure on left ventricular output in newborn lambs.
        Circ Res. 1990; 67: 78-83
        • Downing SE
        • Talner NS
        • Gardner TM
        Ventricular function in the newborn lamb.
        Am J Physiol. 1965; 208: 931-937