AUTHOR=Sabatino Jolanda , Leo Isabella , Strangio Antonio , Bella Sabrina La , Borrelli Nunzia , Avesani Martina , Josen Manjit , Paredes Josefa , Piccinelli Enrico , Sirico Domenico , Pergola Valeria , Fraisse Alain , De Rosa Salvatore , Indolfi Ciro , Di Salvo Giovanni 

TITLE=Echocardiographic Normal Reference Ranges for Non-invasive Myocardial Work Parameters in Pediatric Age: Results From an International Multi-Center Study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.792622

DOI=10.3389/fcvm.2022.792622

ISSN=2297-055X

ABSTRACT=Aims. This international multi-center study aimed to demonstrate feasibility and reliability of non-invasive myocardial work (MW) parameters in paediatric population, providing normal reference ranges for this useful echocardiographic tool in this specific subset of patients. 
Methods and results. One hundred fifty healthy children and adolescents (mean age of 10.6±4.5, 91 males) have been enrolled in this in this retrospective multi-center study involving three Paediatric laboratories. A complete echocardiographic examination has been performed, including Global longitudinal strain assessment.  The following parameters of Non-invasive MW have been obtained through a dedicated software:  Global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE), using LV strain loops and non-invasive brachial artery cuff pressure values. The lowest expected values were for GWI 1723 mmHg% in males and 1682 mmHg% in females, for GCW 2089 mmHg% and 2106 mmHg%, for GWE 95.9% and 95.5% whereas the highest expected value for GWW was 78 mmHg% in men and 90 mmHg% in women. The univariable and multivariable analysis showed significant associations between either GWI or GCW with SBP (β coefficient=0.446, p<0.001; β coefficient=0.456, p<0.001 respectively) and LV GLS (β coefficient=−0.268, p=0.001; β coefficient=−0.233, p=0.003 respectively). Inter- and intra-observer variability showed good reproducibility of non-invasive MW parameters.
Conclusion. Non-invasive MW parameters were feasible and reliable in paediatric population. This study provided normal reference ranges of these useful echocardiographic indices.