© 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



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



ChildrenÕs Heart Center Nevada, 3006 S Maryland Pkwy, ste 690, Las Vegas, NV 89109, USA.

E-mail: wnevans50@aol.com.



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.


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