Starship Paediatric Echocardiography

Reference Values
M-mode Normal values from Z scores
Volumes (Bullet/Area-Length) Normal values from Z scores

3D Volumes1
Data expressed as mean + SD
Age (y)
Variable <1 >1 to < 5 > 5 to < 9 > 9 to < 13 > 13 to < 18
LVEDV (mL) 14.76 + 5.59 22.49 + 7.38 41.22 + 11.95 53.52 + 13.94 81.78 + 26.44
LVESV (mL) 5.63 + 2.48 8.08 + 2.64 15.21 + 4.33 19.47 + 5.9 30.34 + 10.23
LVEF (%) 62.08 + 4.72 63.63 + 5.47 63.15 + 4.81 63.5 + 5.98 62.55 + 4.86

Global Longitudinal Strain2

Note: vendor and software dependent
Data expressed as mean + SD
Age (y)
Variable 0 1-4 5-9 10-14 15-19
Septum
Basal -17.0 +2.6 -19.6 + 1.5 -20.1 + 1.8 -20.0 + 1.7 -20.4 + 1.6
Mid -18.2 + 2.7 -20.9 + 1.3 -21.1 + 1.4 -21.5 + 1.6 -22.5 + 1.4
Apical -20.4 + 1.9 -22.7 + 1.7 -22.6 + 1.5 -23.8 + 1.3 -25.1 + 1.2
Lateral wall
Apical -19.6 +1.5 -22.5 + 1.7 -22.6 + 1.5 -23.9 + 1.7 -25.0 + 1.4
Mid -16.2 + 1.1 -20.2 + 1.6 -20.1 + 1.8 -21.7 + 1.6 -22.4 + 1.7
Basal -15.8 + 1.3 -19.4 + 1.5 -19.3 +1.8 -20.0 + 1.2 -20.5 + 1.7
Global S-L -18.3 + 1.9 -20.7 + 1.3 -21.0 + 1.3 -21.8 + 1.3 -22.5 + 1.3
5th percentile global S-L -14.5 -18.1 -18.4 -19.2 -19.9
95th percentile global S-L -22.1 -23.3 -23.6 -24.4 -25.1

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Starship Paediatric Echocardiography
MV Inflow Doppler3
Data expressed as mean + SD. Doppler velocities expressed as cm/s

Age (y)
Demographics <1 1-5 6-9 10-13 14-18
Mitral E velocity 79.7 +18.8 95.2 + 19.5 94.4 + 14.8 94.5 + 16.0 90.3 + 17.8
Mitral A velocity 65.3+ 13.3 61.3 + 12.1 49.4 + 12.5 49.5 + 13.8 45.5 + 13.2
Mitral E/A ratio 1.25 + 0.30 1.60 + 0.46 1.99 + 0.51 2.02 + 0.58 2.13 + 0.65

Pulmonary Venous Doppler3

Data expressed as mean + SD. Doppler velocities expressed as cm/s

Age (y)
Demographics <1 1-5 6-9 10-13 14-18
PV A-reversal velocity 16.4 +6.3 20.6 + 4.3 20.2 + 3.87 21.2 + 4.9 20.0 + 5.2

MAPSE4

Age Range
Months
1 0.38 – 0.76
2 0.47 – 0.86
3 0.50 – 0.96
4-6 0.56 – 0.97
7-9 0.63 – 1.06
10-12 0.70 – 1.13
Years
2 0.87 – 1.28
3 0.92 – 1.31
4 0.93 – 1.36
5 0.92 – 1.48
6 1.03 – 1.54
7 1.08 – 1.49
8 1.05 – 1.53
9 1.04 – 1.73
10 1.11 – 1.64
11 1.20 – 1.55
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Starship Paediatric Echocardiography

12 1.16 – 1.66
13 1.20 – 1.71
14 1.21 – 1.69
15 1.32 – 1.84
16 1.34 – 1.93
17 1.30 – 1.93
18 1.31 – 1.95

MPI5
TDI 0.38 + 0.06 (upper limit normal 0.5)

Data expressed as mean + SD

The effects of age, body surface area or heart rate not clinically significant

TDI3
Data expressed as mean + SD (95% confidence interval). Doppler tissue imaging velocities are expressed in cm/s

Age Group E’wave velocity A’ wave velocity S’-wave velocity E/E’ ratio
Mitral annular
<1 y 8.8 – 10.5 5.3 – 6.2 5.3 – 6.1 8.1 – 9.5
1-5 y 14.3 – 15.4 6.1 – 7.0 7.2 – 8.2 6.0 – 7.0
6-9 y 16.2 – 18.3 6.2 – 7.3 8.9 – 10.1 5.3 – 6.4
10-13 y 18.7 – 20.5 5.9 – 6.9 10.0 – 11.5 4.6 – 5.2
14-18 y 19.7 – 21.4 6.3 – 7.1 11.6 – 12.9 4.4 – 5.0
Septal
<1y 7.5 – 8.7 5.7 – 6.4 5.1 – 5.7 9.7 – 11.0
1-5 y 11.3 – 12.3 5.7 – 6.4 6.8 – 7.5 7.7 – 8.5
6-9 y 12.8 – 13.9 5.5 – 6.3 7.6 – 8.4 6.8 – 7.7
10-13 y 13.8 – 15.2 5.6 – 6.7 7.9 – 8.5 6.3 – 7.0
14-18 y 14.3 – 15.4 5.9 – 6.6 8.7 – 9.3 6.1 – 6.8

LV Mass index by M-mode in Children6

< 38 g/m2.7 normal

38-51 g/m2.7 mild-moderate LVH
> 51 g/m2.7 severe LVH

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Starship Paediatric Echocardiography
Mass/Volume Ratio

> 1.1 abnormal

References
1. Zhang, L. Left Ventricular Three-Dimensional Global Systolic Strain by Real-Time Three-Dimensional Speckle-
Tracking in Children: Feasibility, Reproducibility, Maturational Changes, and Normal Ranges. Journal of the
American Society of Echocardiography 2013; Volume 26 Number 8
2. Marcus KA. Reference Values for Myocardial Two-Dimensional Strain Echocardiography in a Healthy
Pediatric and Young Adult Cohort. J Am Soc Echocardiogr 2011;24:625-36
3. Eidem B.W. Impact of cardiac growth on Doppler tissue imaging velocities: a study in healthy children. J Am Soc
Echocardiogr 2004;17:212-21
4. Koestenberger. M. Left ventricular long-axis function: Reference values of the mitral annular plane systolic
excursion in 558 healthy children and calculation of z-score values. Am Heart J 2012;164:125-31
5. Cui W, Roberson D.A. Left Ventricular Tei Index in Children; Comparison of Tissue Doppler Imaging, Pulsed
Wave Doppler, and M-mode Echocardiography Normal Values. J Am Soc Echocardiogr 2006;19:1438-1445.
6. Investigation of Hypertension in Childhood. Chapter 42, page 654

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