Normalization of Cardiac Structural dimension and Function to Body Surface Area in South East Nigeria Children

Abstract

ABSTRACT Background: Standardizing cardiac valve structures and function to body surface area will help the clinician and surgeons in decision-making. Aim: To evaluate the z-scores of the sizes of cardiac structures and function and to present them in Gaussian curves and reference values. Materials and Methods: This was a cross-sectional study that involved 300 apparently healthy children. This study was performed among healthy children from birth to 18 years. Children with a normal echocardiogram, those with no chronic illness, no congenital heart defect, and no acquired heart defect were included in the study. Result: The majority fell within the normal limits, as shown in the Gaussian curves. For instance, 40 (13.3%) of atrioventricular (AV) valve diameters were +1 Z-score above the normal, and only 5 (1.7%) were +2 Z-score above the normal. About 9.3% (28/300) had below −2 Z-score below normal, while only 5% had −1 Z-score below normal. Similarly, the left ventricular function z-scores were also derived at −3 Z-scores to +3 Z-scores. The standard reference values were compared with the results obtained from our Z score values. There was no significant difference noted in the Z-scores. P values ranged from 0.07 to 0.84 for all the cardiac structures except for gender, where Z-scores of the mitral valve and left pulmonary artery varied significantly (P = 0.02). Conclusion: Reference values of cardiac structure and function were presented using Z scores, and we noted no significant difference when compared with the Western standard values except for the mitral valve and left pulmonary artery.