Journal of the American Society of Echocardiography
Clinical InvestigationEchocardiography in ChildrenNew Comprehensive Reference Values for Arterial Vascular Parameters in Children
Section snippets
Subjects
This study was approved by the Hospital for Sick Children's research ethics board and carried out in accordance with the code of ethics of the World Medical Association (Declaration of Helsinki). Study participation required written informed parental consent as well as assent from participants who were old enough to understand the proposed research.
Healthy subjects aged 0 to 18 years were recruited from local public schools and from the low-risk heart murmur referral clinic at the Hospital for
Study Population
Table 1 and Figure 1 respectively detail the characteristics and age distribution of the 292 study subjects. Stiffness index, CPWV, and pressure-strain elastic modulus were obtained in 273 children (age range: 0.0–17.9 years), carotid intima-media thickness in 204 children (age range: 8.0–17.9 years), flow-mediated dilation in 182 children (age range: 8.3–17.9 years), and augmentation index, cfPWV, crPWV, and PWV ratio in 198 children (age range: 5.5–17.9 years). The median and interquartile
Discussion
In this study, we propose pediatric reference values for a comprehensive set of vascular parameters. Using multivariate regression models, we were able to adjust for the physiologic effects of weight, height, and age. The proposed Z scores are independent of these variables, and their validity is strengthened by the absence of departure from a normal distribution.
The relationship of vascular parameters with age and anthropometric variables is complex. In contrast to adults, there are
Conclusion
In this study, we propose Z score equations for pediatric reference values for a comprehensive set of vascular parameters. These reference values should help better differentiate the physiologic effects of age and body size from the pathologic effects of disease. Further studies are needed to evaluate the role of these vascular parameters in identifying cardiovascular risks.
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Dr. Torigoe holds a scholarship from Niigata Prefectural Welfare Federation of Agricultural Cooperative, Japan. Dr. Dallaire is supported in part by unrestricted salary support from Fonds de Recherche du Québec - Santé.
Conflicts of interest: None.
Drs. Torigoe and Dallaire contributed equally to this work.