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British Heart Journal logoLink to British Heart Journal
. 1995 Apr;73(4):334–339. doi: 10.1136/hrt.73.4.334

Left ventricular diastolic function in children measured by Doppler echocardiography: normal values and relation with growth.

F A Bu'Lock 1, M G Mott 1, R P Martin 1
PMCID: PMC483826  PMID: 7756066

Abstract

OBJECTIVES--To determine normal values for variables of left ventricular diastolic function in children measured by Doppler echocardiography and their relations to body surface area (BSA). BACKGROUND--There is increasing interest in echocardiographic assessment of left ventricular diastolic function in children but normal data for children are limited. METHODS--Assessment of left ventricular diastolic function was performed in 130 normal participants (aged from 2.4 months to 19.6 years) from their transmitral flow patterns obtained by pulsed wave Doppler echocardiography. RESULTS--Centile charts for commonly used left ventricular diastolic functional variables plotted against BSA are presented. Peak early diastolic filling velocity and atrial phase filling velocity integral were independent of BSA. Although most other filling indices showed strong relations with BSA, some had more curvilinear relations with BSA due to additional interactions with heart rate. The increase in left ventricular filling with growth is largely achieved by an increase in the early "passive" contribution to filling. The slower heart rates of older children are associated with lower atrial phase filling velocities but increased filling time, so the atrial contribution to filling remains relatively constant. CONCLUSIONS--Normal values of many left ventricular diastolic function variables change with growth in children and cannot be extrapolated from adult data. The data presented are suitable for use in size matched matched comparative studies of left ventricular function in children. Careful standardisation of echocardiographic protocols is necessary to ensure the validity of any comparisons.

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Selected References

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  1. Appleton C. P., Hatle L. K., Popp R. L. Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined hemodynamic and Doppler echocardiographic study. J Am Coll Cardiol. 1988 Aug;12(2):426–440. doi: 10.1016/0735-1097(88)90416-0. [DOI] [PubMed] [Google Scholar]
  2. Brecker S. J., Lee C. H., Gibson D. G. Relation of left ventricular isovolumic relaxation time and incoordination to transmitral Doppler filling patterns. Br Heart J. 1992 Dec;68(6):567–573. doi: 10.1136/hrt.68.12.567. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Dabestani A., Takenaka K., Allen B., Gardin J. M., Fischer S., Russell D., Henry W. L. Effects of spontaneous respiration on diastolic left ventricular filling assessed by pulsed Doppler echocardiography. Am J Cardiol. 1988 Jun 1;61(15):1356–1358. doi: 10.1016/0002-9149(88)91187-3. [DOI] [PubMed] [Google Scholar]
  4. Fast J., Van Dam I., Heringa A., De Boo T., Alsters J., Hopman J., Daniels O., Van den Merkhof L. Limits of reproducibility of mitral pulsed Doppler spectra. Am J Cardiol. 1988 Apr 15;61(11):891–894. doi: 10.1016/0002-9149(88)90365-7. [DOI] [PubMed] [Google Scholar]
  5. Gardin J. M., Dabestani A., Takenaka K., Rohan M. K., Knoll M., Russell D., Henry W. L. Effect of imaging view and sample volume location on evaluation of mitral flow velocity by pulsed Doppler echocardiography. Am J Cardiol. 1986 Jun 1;57(15):1335–1339. doi: 10.1016/0002-9149(86)90214-6. [DOI] [PubMed] [Google Scholar]
  6. Grenadier E., Oliveira Lima C., Allen H. D., Sahn D. J., Vargas Barron J., Valdes-Cruz L. M., Goldberg S. J. Normal intracardiac and great vessel Doppler flow velocities in infants and children. J Am Coll Cardiol. 1984 Aug;4(2):343–350. doi: 10.1016/s0735-1097(84)80224-7. [DOI] [PubMed] [Google Scholar]
  7. Harrison M. R., Clifton G. D., Pennell A. T., DeMaria A. N. Effect of heart rate on left ventricular diastolic transmitral flow velocity patterns assessed by Doppler echocardiography in normal subjects. Am J Cardiol. 1991 Mar 15;67(7):622–627. doi: 10.1016/0002-9149(91)90902-w. [DOI] [PubMed] [Google Scholar]
  8. Heusch G. Alpha-adrenergic mechanisms in myocardial ischemia. Circulation. 1990 Jan;81(1):1–13. doi: 10.1161/01.cir.81.1.1. [DOI] [PubMed] [Google Scholar]
  9. Johnson G. L., Moffett C. B., Jurnalov C. D., Noonan J. A. Effect of sample volume location on pulsed Doppler diastolic flow parameters in newborn infants. Pediatr Cardiol. 1988;9(4):221–224. doi: 10.1007/BF02078412. [DOI] [PubMed] [Google Scholar]
  10. Johnson G. L., Moffett C. B., Noonan J. A. Doppler echocardiographic studies of diastolic ventricular filling patterns in premature infants. Am Heart J. 1988 Dec;116(6 Pt 1):1568–1574. doi: 10.1016/0002-8703(88)90745-4. [DOI] [PubMed] [Google Scholar]
  11. Kuo L. C., Quinones M. A., Rokey R., Sartori M., Abinader E. G., Zoghbi W. A. Quantification of atrial contribution to left ventricular filling by pulsed Doppler echocardiography and the effect of age in normal and diseased hearts. Am J Cardiol. 1987 May 1;59(12):1174–1178. doi: 10.1016/0002-9149(87)90870-8. [DOI] [PubMed] [Google Scholar]
  12. Labovitz A. J., Pearson A. C. Evaluation of left ventricular diastolic function: clinical relevance and recent Doppler echocardiographic insights. Am Heart J. 1987 Oct;114(4 Pt 1):836–851. doi: 10.1016/0002-8703(87)90795-2. [DOI] [PubMed] [Google Scholar]
  13. Loeber C. P., Goldberg S. J., Allen H. D. Doppler echocardiographic comparison of flows distal to the four cardiac valves. J Am Coll Cardiol. 1984 Aug;4(2):268–272. doi: 10.1016/s0735-1097(84)80212-0. [DOI] [PubMed] [Google Scholar]
  14. Nishimura R. A., Abel M. D., Hatle L. K., Tajik A. J. Assessment of diastolic function of the heart: background and current applications of Doppler echocardiography. Part II. Clinical studies. Mayo Clin Proc. 1989 Feb;64(2):181–204. doi: 10.1016/s0025-6196(12)65673-0. [DOI] [PubMed] [Google Scholar]
  15. Nishimura R. A., Housmans P. R., Hatle L. K., Tajik A. J. Assessment of diastolic function of the heart: background and current applications of Doppler echocardiography. Part I. Physiologic and pathophysiologic features. Mayo Clin Proc. 1989 Jan;64(1):71–81. doi: 10.1016/s0025-6196(12)65305-1. [DOI] [PubMed] [Google Scholar]
  16. Oniki T., Hashimoto Y., Shimizu S., Kakuta T., Yajima M., Numano F. Effect of increasing heart rate on Doppler indices of left ventricular performance in healthy men. Br Heart J. 1992 Oct;68(4):425–429. doi: 10.1136/hrt.68.10.425. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Riggs T. W., Rodriguez R., Snider A. R., Batton D. Doppler echocardiographic evaluation of right and left ventricular diastolic function in normal neonates. J Am Coll Cardiol. 1989 Mar 1;13(3):700–705. doi: 10.1016/0735-1097(89)90614-1. [DOI] [PubMed] [Google Scholar]
  18. Riggs T. W., Snider A. R. Respiratory influence on right and left ventricular diastolic function in normal children. Am J Cardiol. 1989 Apr 1;63(12):858–861. doi: 10.1016/0002-9149(89)90057-x. [DOI] [PubMed] [Google Scholar]
  19. Sahn D. J., DeMaria A., Kisslo J., Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation. 1978 Dec;58(6):1072–1083. doi: 10.1161/01.cir.58.6.1072. [DOI] [PubMed] [Google Scholar]
  20. Smith S. A., Stoner J. E., Russell A. E., Sheppard J. M., Aylward P. E. Transmitral velocities measured by pulsed Doppler in healthy volunteers: effects of acute changes in blood pressure and heart rate. Br Heart J. 1989 Apr;61(4):344–347. doi: 10.1136/hrt.61.4.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Spirito P., Maron B. J. Doppler echocardiography for assessing left ventricular diastolic function. Ann Intern Med. 1988 Jul 15;109(2):122–126. doi: 10.7326/0003-4819-109-2-122. [DOI] [PubMed] [Google Scholar]
  22. Spirito P., Maron B. J., Verter I., Merrill J. S. Reproducibility of Doppler echocardiographic measurements of left ventricular diastolic function. Eur Heart J. 1988 Aug;9(8):879–886. doi: 10.1093/oxfordjournals.eurheartj.a062582. [DOI] [PubMed] [Google Scholar]
  23. Stewart R. A., Joshi J., Alexander N., Nihoyannopoulos P., Oakley C. M. Adjustment for the influence of age and heart rate on Doppler measurements of left ventricular filling. Br Heart J. 1992 Dec;68(6):608–612. doi: 10.1136/hrt.68.12.608. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Stoddard M. F., Pearson A. C., Kern M. J., Ratcliff J., Mrosek D. G., Labovitz A. J. Influence of alteration in preload on the pattern of left ventricular diastolic filling as assessed by Doppler echocardiography in humans. Circulation. 1989 Jun;79(6):1226–1236. doi: 10.1161/01.cir.79.6.1226. [DOI] [PubMed] [Google Scholar]
  25. Uiterwaal C., Van Dam I., De Boo T., Van Keulen P., Folgering H., Hopman J., Daniels O. The effect of respiration on diastolic blood flow velocities in the human heart. Eur Heart J. 1989 Feb;10(2):108–112. doi: 10.1093/oxfordjournals.eurheartj.a059449. [DOI] [PubMed] [Google Scholar]

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