© 2009 Copyright the
Authors
Journal Compilation ©
2009 Wiley Periodicals, Inc.
Congenit Heart Dis. 2009;4:91–95
Simple Echocardiographic Evaluation of Right Ventricular
Size
in Children
Authors
William N Evans, MD, Ruben J Acherman, MD, FACC, Gary A Mayman,
MD, FACC, Dean P Berthoty, MD, Robert C Rollins, MD, FACC, Katrina Kip, MD,
FACC, Humberto Restrepo, MD, MPH
Source
ChildrenÕs Heart Center Nevada, 3006 S Maryland Pkwy, ste 690,
Las Vegas, NV 89109, USA.
E-mail: wnevans50@aol.com.
Abstract
Objective. The objective of this study was to develop a rapid,
semiquantitative two-dimensional echocardiographic method to evaluate right
ventricular size.
Background. Abnormal right ventricular size, secondary to right ventricular
volume loading conditions, influences clinical recommendations. Because of
convoluted right ventricular geometry, measuring right ventricular volume quantitatively
requires complex invasive or noninvasive methods.
Methods. We defined a normal right ventricular diastolic area index
(RVDAI) via two-dimensional echocardiographic right ventricular diastolic
measurements from 100 children (newborn to 18 years, mean = 6.6 years) with innocent
murmurs. We measured RVDAs from the apical 4-chamber (RVDA4c) and the short
axis (RVDAsax), and left and right ventricular end-diastolic, M-mode dimensions
from the long-axis view (LVEDD; RVEDD). We calculated an RVDAI from the
formula: ([{RVDA4c + RVDAsax}/2]/BSA) ´ (RVEDD/LVEDD)3.
We obtainedRVDAI values from 19 children with secundum atrial septal defects or
pulmonary valve regurgitation. The pulmonary valve regurgitation patients also
underwent cardiac magnetic resonance imaging 0–6 weeks from their two dimensional echocardiogram.
Results. In normal patients, the RVDAI was _1.0 for body surface areas
>0.5 m2. The RVDAIs for body surface areas <0.5 m2
increased exponentially with decreasing body surface area. In patients with
heart disease, the RVDAI correlated with atrial septal defectÕs size and right
ventricular volume measured by cardiac magnetic resonance imaging.
Conclusions. The RVDAI is a rapid, semiquantitative two-dimensional
echocardiographic method for serially evaluating right ventricular size.