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LETTER TO EDITOR
Year : 2019  |  Volume : 29  |  Issue : 1  |  Page : 43

Reference values of longitudinal systolic right and left ventricular function measured by M-mode echocardiography in healthy preterm and term neonates


Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Web Publication20-Mar-2019

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
P. O. Box: 55302, Baghdad Post Office, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcecho.jcecho_67_18

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How to cite this article:
Al-Mendalawi MD. Reference values of longitudinal systolic right and left ventricular function measured by M-mode echocardiography in healthy preterm and term neonates. J Cardiovasc Echography 2019;29:43

How to cite this URL:
Al-Mendalawi MD. Reference values of longitudinal systolic right and left ventricular function measured by M-mode echocardiography in healthy preterm and term neonates. J Cardiovasc Echography [serial online] 2019 [cited 2019 Nov 14];29:43. Available from: http://www.jcecho.org/text.asp?2019/29/1/43/254600



Dear Sir,

I have two comments on the interesting study by Ghandi et al.[1] published in the July–September 2018 issue of the Journal of Cardiovascular Echography.

First, the authors found on employing M-mode echocardiography that the mean lateral (LAT) mitral annular plane systolic excursion (MAPSE) was 0.63 ± 0.11 cm for gestational age (GA) of 30–33 weeks, 0.76 ± 0.03 cm among GA of 34–36 weeks, and 0.84 ± 0.08 cm for GA of 37–40 weeks; the mean septal (SEP) MAPSE was 0.39 ± 0.14 cm, 0.51 ± 0.06 cm, and 0.65 ± 0.09 cm, respectively; and the mean tricuspid annular plane systolic excursion (TAPSE) was 0.47 ± 0.13 cm, 0.62 ± 0.07 cm, and 0.88 ± 0.15 cm, respectively. The mean LAT MAPSE was 0.63 ± 0.09 cm for neonates weighing 1500–2500 g and 0.82 ± 0.06 cm for those weighing 2500–3600 g; the mean SEP MAPSE was 0.39 ± 0.11 cm and 0.61 ± 0.09 cm, respectively. There was a positive correlation between LAT MAPSE with body surface area (BSA) and body weight (BW) (P = 0.0001). In addition, SEP MAPSE showed a positive correlation with BSA and BW (P = 0.0001). There was a positive correlation between TAPSE with BSA (P = 0.0001) and BW (P = 0.0001).[1] Accordingly, the authors set the reference values for evaluating global neonatal ventricular systolic function to be used in the clinical field and researches.[1] The authors addressed few limitations that might cast some suspicions on the accuracy of the study results and their constructed reference values. I presume that the following limitation might be additionally relevant. It is obvious that the population in India is polygenetic with different races and cultures. In the methodology, the authors did not state the exact ethnic backgrounds of the studied population. This point is important to be considered as many echocardiographic parameters have been noticed to vary among different ethnic groups,[2],[3],[4] and hence, the construction of ethnic-appropriate echocardiographic reference values is suggested to be employed in the clinical settings and research field.

Second, it is explicit that cardiovascular magnetic resonance (CMR) is regarded the gold standard method for the evaluation of various cardiac structures and function and it allows the differentiation between pathological and normal states. Importantly, CMR-specific reference ranges for various cardiac parameters have been constructed in certain populations.[5] To accurately construct the normal reference values for global ventricular systolic function for neonates in India, CMR employment in a wide scale multicenter study is advocated.

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  References Top

1.
Ghandi Y, Habibi D, Farahani E. Reference values of longitudinal systolic right and left ventricular function measured by M-mode echocardiography in healthy preterm and term neonates. J Cardiovasc Echogr 2018;28:177-81.  Back to cited text no. 1
    
2.
Echocardiographic Normal Ranges Meta-Analysis of the Left Heart Collaboration. Ethnic-specific normative reference values for echocardiographic LA and LV size, LV mass, and systolic function: The EchoNoRMAL study. JACC Cardiovasc Imaging 2015;8:656-65.  Back to cited text no. 2
    
3.
Cosyns B, Lancellotti P. Normal reference values for echocardiography: A call for comparison between ethnicities. Eur Heart J Cardiovasc Imaging 2016;17:523-4.  Back to cited text no. 3
    
4.
Moreira HT, Nwabuo CC, Armstrong AC, Kishi S, Gjesdal O, Reis JP, et al. Reference ranges and regional patterns of left ventricular strain and strain rate using two-dimensional speckle-tracking echocardiography in a healthy middle-aged black and white population: The CARDIA study. J Am Soc Echocardiogr 2017;30:647-5800.  Back to cited text no. 4
    
5.
Petersen SE, Aung N, Sanghvi MM, Zemrak F, Fung K, Paiva JM, et al. Reference ranges for cardiac structure and function using cardiovascular magnetic resonance (CMR) in Caucasians from the UK Biobank population cohort. J Cardiovasc Magn Reson 2017;19:18.  Back to cited text no. 5
    




 

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