Quantitative Echocardiography: A Study of Champion Childhood Athletes

Although most pediatric echocardiographic criteria have been concerned with qualitative aspects of cardiac anatomy, dimensional quantitation has demonstrated utility in children with lesions causing cardiac pressure or volume overloads. Examples of this include following left atrial dimension in children with patent ductus, or ventricular septal defect and right ventricular anterior wall thickness in cor pulmonale. In order to utilize quantitative echographic techniques, normal chamber and great vessel dimensions established during a collaborative study from the Universities of Arizona and Indiana were derived and presented last year at this meeting by Epstein. The study established percentile nomograms which compared direct echocardiographic measurements of walls, chambers and great vessels in unselected normal healthy children to the best correlate, body surface area. These nomograms have been utilized as a basis for reading echocardiograms of children evaluated for various reasons in our cardiac clinics. A number of athletic youngsters with normal hearts were found to have excessive echocardiographic dimensions. Accordingly, it became clear that more definition of the upper 5th percentile was required. In order to define this range, we selected the best available group of highly trained childhood athletes, competitive swimmers.