ArticleJournal of the American Society of Echocardiography : official publication of the American Society of Echocardiography2019
Challenges With Left Ventricular Functional Parameters: The Pediatric Heart Network Normal Echocardiogram Database.
Article in Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 30 citations in OpenAlex.
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- A Multi-Task Deep Learning Model for Pediatric Echocardiography Analysis.medRxiv : the preprint server for health sciences · 2025Article
- Evaluating Frequency and Yield of Echocardiography in a Pediatric Intensive Care Unit.Journal of pediatrics. Clinical practice · 2025Article
- Pediatric ECG-Based Deep Learning to Predict Left Ventricular Dysfunction and Remodeling.Circulation · 2024Article
- Cardiotoxicity of CPX-351 in children and adolescents with relapsed AML: a Children's Oncology Group report.Frontiers in cardiovascular medicine · 2024Article
- Longitudinal strain analysis for assessment of early cardiotoxicity during anthracycline treatment in childhood sarcoma: A single center experience.Cancer reports (Hoboken, N.J.) · 2023Article
- Rationale and design of the Children's Oncology Group study AAML1831 integrated cardiac substudies in pediatric acute myeloid leukemia therapy.Frontiers in cardiovascular medicine · 2023Article
- Sustained improvement in fellows' echocardiographic completeness through the coronavirus pandemic with a standardised imaging protocol.Cardiology in the young · 2023Article
- Cardiac dysfunction in medulloblastoma survivors treated with photon irradiation.Neuro-oncology practice · 2022Article
- Pediatric Cardio-Oncology Medicine: A New Approach in Cardiovascular Care.Children (Basel, Switzerland) · 2021Review
- Diastolic Function and Ambulatory Hypertension in Children With Chronic Kidney Disease.Hypertension (Dallas, Tex. : 1979) · 2021Observational
- Non-invasive left ventricular myocardial work indices in healthy adolescents at rest.The international journal of cardiovascular imaging · 2021Article
- Echocardiographic myocardial strain analysis describes subclinical cardiac dysfunction after craniospinal irradiation in pediatric and young adult patients with central nervous system tumors.Cardio-oncology (London, England) · 2021Article
- Improving reproducibility of left ventricular ejection fraction in pediatric oncology patients: less is more.The international journal of cardiovascular imaging · 2020Article
- Myocardial Dysfunction Is Independently Associated With Mortality in Pediatric Septic Shock.Critical care explorations · 2020Article
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Authors and funding
29 authors at 20 institutions in 2 countries.
Funding
Abstract
backgroundThe reliability of left ventricular (LV) systolic functional indices calculated from blinded echocardiographic measurements of LV size has not been tested in a large cohort of healthy children. The objective of this study was to estimate interobserver variability in standard measurements of LV size and systolic function in children with normal cardiac anatomy and qualitatively normal function.
methodsThe Pediatric Heart Network Normal Echocardiogram Database collected normal echocardiograms from healthy children ≤18 years old distributed equally by age, gender, and race. A core lab used two-dimensional echocardiograms to measure LV dimensions from which a separate data coordinating center calculated LV volumes and systolic functional indices. To evaluate interobserver variability, two independent expert pediatric echocardiographic observers remeasured LV dimensions on a subset of studies, while blinded to calculated volumes and functional indices.
resultsOf 3,215 subjects with measurable images, 552 (17%) had a calculated LV shortening fraction (SF) < 25% and/or LV ejection fraction (EF) < 50%; the subjects were significantly younger and smaller than those with normal values. When the core lab and independent observer measurements were compared, individual LV size parameter intraclass correlation coefficients were high (0.81-0.99), indicating high reproducibility. The intraclass correlation coefficients were lower for SF (0.24) and EF (0.56). Comparing reviewers, 40/56 (71%) of those with an abnormal SF and 36/104 (35%) of those with a normal SF based on core lab measurements were calculated as abnormal from at least one independent observer. In contrast, an abnormal EF was less commonly calculated from the independent observers' repeat measures; only 9/47 (19%) of those with an abnormal EF and 8/113 (7%) of those with a normal EF based on core lab measurements were calculated as abnormal by at least one independent observer.
conclusionsAlthough blinded measurements of LV size show good reproducibility in healthy children, subsequently calculated LV functional indices reveal significant variability despite qualitatively normal systolic function. This suggests that, in clinical practice, abnormal SF/EF values may result in repeat measures of LV size to match the subjective assessment of function. Abnormal LV functional indices were more prevalent in younger, smaller children.
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