The Ventricular Volume Variability Study (VVV) examined the differences in left heart ventricle mass, volume and ejection fraction in pediatric patients with dilated cardiomyopathy.
Echocardiograms are the primary method to evaluate the size of the heart and how it functions. Healthcare providers did not know how reproducible some of the measurements were, especially in children.
This study was done to help us understand why there might be errors in measurements and the true change in heart function values over time. The study began on May 16, 2005 and the last patient was enrolled in July 2007 with 131 individuals enrolled.
Were enrolled in this study.
Beat averaging and a single core lab observer improved the reproducibility of echocardiographic measurements in children with dilated cardiomyopathy.
Certain measurements were highly reproducible, while others, despite beat averaging, were poorly reproducible.
Each qualified person had data collected on labs, tests and procedures that were done as part of routine clinical care. A second set of measurements were done when each routine echocardiogram was performed during a one year period of time (with at least 3 months in between each test).
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There are multiple echocardiographic methods in common clinical use for measuring left ventricular size and function. Clinical management is often based on both individual evaluations and longitudinal trends, but it is generally not possible or practical to have the same personnel perform and interpret the echocardiographic assessment over time. Using data from the PHN’s, Ventricular Volume Study in children with dilated cardiomyopathy, we investigated the impact of observer and sonographer variation on reproducibility of dimension, area, and volume methods to determine the most reproducible method for both individual and sequential evaluations. Compared to dimension and area methods, left ventricular measurements by volume method have the best reproducibility in settings where assessment is not performed by the same personnel. In an era in which left ventricular function is not assessed routinely by volume methods (i.e., ejection fraction) in many pediatric echocardiographic laboratories, this study provides important information on reproducibility that could impact long-term management of pediatric dilated cardiomyopathy.
G. Baker, J Am Soc Enchocardiogr 2008; 21(3):230-233.
“Dyssynchrony” means that parts of the heart do not squeeze at the same time. This causes less efficient ejection of blood and contributes to heart failure. There is little data on dyssynchrony in children. This small study looked at whether 3-dimensional echocardiography (heart ultrasound) can be used to identify dyssynchrony in healthy children and children with poor heart function. The results show that 3D echocardiography can be used to look at dyssynchrony in children, and that patients with poorer heart function have more dyssynchrony.