Abstract
An established echocardiographic (echo) standard for assessing the newborn right ventricle (RV) for hypertrophy has not been thoroughly developed. This is partially due to the RV’s complex architecture, which makes quantification of RV mass by echo difficult. Here, we retrospectively evaluate the thickness of the inferior RV wall (iRVWT) by echo in neonates and infants with normal cardiopulmonary physiology. Inferior RVWT was defined at the medial portion of the inferior wall of the RV at the mid-ventricular level, collected from a subxiphoid, short axis view. iRVWT was indexed to body surface area (BSA) to the 0.5 power and normalized to iLVWT to explore the best normalization method. Ninety-eight neonates and 32 infants were included in the final analysis. Mean age for neonates and infants was 2 days and 59 days, respectively. Mean ± SD for neonate and infant end-diastole iRVWT was 2.17 ± 0.35 mm and 1.79 ± 0.28 mm, respectively. There was no residual relationship between the index iRVWT and BSA (r = 0.03, p = NS). In the infant cohort, the iRVWT was significantly lower and iLVWT was significantly higher compared to neonate, consistent with known physiologic changes of RV and LV mass. Thus, iRVWT may serve as a reliable and accurate proxy for RV mass and the parameter warrants further evaluation.
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Data Availability
Deidentified individual participant data, in addition to study protocols, will be made available. The data will be made available on publication to researchers who provide a methodologically sound proposal for use in achieving the goals of the approved proposal. Proposals should be submitted to Dr. James C. Nielsen at james.nielsen@nyulangone.org.
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Dr. JCN and Dr. HDP conceptualized and designed the study. Data collection were performed by Drs. JCN, EH, and HDP. All authors performed data analysis. The first draft of the manuscript was written by Dr. JCN and Dr. HDP and all authors commented on subsequent versions of the manuscript. All authors read and approved the final manuscript.
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This research study was conducted retrospectively from data obtained for clinical purposes. We consulted extensively with the NYU School of Medicine Institutional Review Board (IRB) who approved this study. An IRB official waiver of authorization to use identifiable health information for research was granted from the IRB.
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Pravder, H.D., Hodzic, E., Bhatla, P. et al. Inferior Right Ventricular Wall Thickness by Echocardiogram: A Novel Method of Assessing Hypertrophy in Neonates and Infants. Pediatr Cardiol 41, 1617–1622 (2020). https://doi.org/10.1007/s00246-020-02419-7
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DOI: https://doi.org/10.1007/s00246-020-02419-7