儿童和青少年心肌工作的超声心动图参考范围：荟萃分析。

IF 3.2 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology Pub Date : 2025-02-04 DOI:10.1016/j.ijcard.2025.133040

Xander Jacquemyn , Benjamin T. Barnes , Sruti Rao , Shelby Kutty

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Echocardiographic reference ranges of myocardial work in children and adolescents: A meta-analysis

Background

Establishing reference values for LV myocardial work (MW) is essential before its widespread implementation in pediatrics. This study aims to provide normal LV MW ranges, encompassing global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE).

Methods

Databases were searched through February 1st, 2024, for studies reporting MW indices in healthy children across pediatric age categories. Weighted means were obtained from random-effect models with corresponding 95 % confidence intervals (CI). Subgroup analyses were conducted to identify sex or geographic differences. Meta-regression analysis was used to identify modulating effects of demographic, clinical, and echocardiographic variables.

Results

The search yielded 104 articles, of which, 12 articles with 1037 patients (age 10.7 ± 0.7 years, 47.5 % female) were eligible for inclusion. The reported normal overall pooled mean values of GWI and GCW were 1525.4 (95 % CI, 1328.1–1722.6) mmHg% and 1880.3 (95 % CI, 1683.6–2077.0) mmHg%, respectively. Pooled mean GWW was 57.2 (95 % CI, 51.9–62.5) mmHg%, and pooled mean GWE was 96.8 (95 % CI, 96.6–97.0) %. Subgroup analysis found no sex differences (P > 0.050), but significant regional variations: GCW and GWW differed in European or US cohorts versus East Asian cohorts (P = 0.033 and P = 0.039, respectively). Meta-regression identified age, blood pressure, and heart rate as significant modulators. Pooled inter-observer intraclass correlation coefficients (ICCs) ranged from 0.86 to 0.96, while pooled intra-observer ICCs ranged from 0.81 to 0.93, indicating excellent reproducibility.

Conclusions

We provide age-specific MW reference ranges for children, valuable for both clinical and research purposes, and confirm the reproducibility of MW.

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来源期刊

International journal of cardiology 医学-心血管系统

CiteScore

6.80

自引率

5.70%

发文量

758

审稿时长

44 days

期刊介绍： The International Journal of Cardiology is devoted to cardiology in the broadest sense. Both basic research and clinical papers can be submitted. The journal serves the interest of both practicing clinicians and researchers. In addition to original papers, we are launching a range of new manuscript types, including Consensus and Position Papers, Systematic Reviews, Meta-analyses, and Short communications. Case reports are no longer acceptable. Controversial techniques, issues on health policy and social medicine are discussed and serve as useful tools for encouraging debate.