Summary
The normal serial variability of M-mode and digitized echocardiography was assessed in 18 healthy children aged 3–16 years. M-mode echocardiograms were done one month apart in each child and two sets of three beats were analyzed twice for each month's tracing. Ejection fraction and shortening fraction were obtained in the standard manner and the tracing digitized and analyzed for peak and normalized left ventricular velocities, and for posterior wall and septal wall velocities in systole and diastole. The component variabilities were determined by a univariate four-factor hierarchical variance components analysis and the sum of these variability limits established. Standard M-mode echocardiographic measurements of shortening fraction and ejection fraction (15% and 10% of mean) were the least variable. Peak and normalized velocities were more variable with left ventricular velocities (18%–29% of mean), posterior wall velocities (26%–45% of mean) and septal velocities (38%–68% of mean) showing increasing variabilities.
Thus there is less variability in M-mode echocardiography than digitized echocardiography. The normal limits of variability are established and should be used for follow-up studies.
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References
Belenkie I (1979) Beat-to-beat variability of echocardiographic measurements of left ventricular end diastolic diameter and performance.J Clin Ultrasound 7:263–268
Belenkie I, Nutter DO, Clark DW, McGraw DB, Raizner AE (1973) Assessment of left ventricular dimensions and function by echocardiography.Am J Cardiol 31:755–762
Bett JHN, Dryburgh LG (1981) Beat-to-beat variation in echocardiographic measurements of left ventricular dimensions and function.J Clin Ultrasound 9:119–125
Bullock RE, Appleton D, Griffiths C, Albers CJ, Amer H, Hall RJC (1984) Precision of digitized M-mode echocardiograms for clinical practice.Eur Heart J 5:941–947
Clark RD, Korcuska K, Cohn K (1980) Serial echocardiographic evaluation of left ventricular function in valvular disease, including reproducibility guidelines for serial studies.Circulation 62:564–575
Crawford MH, Grant D, O'Rourke RA, Starling MR, Groves BM (1980) Accuracy and reproducibility of new M-mode echocardiographic recommendations for measuring left ventricular dimensions.Circulation 61:137–143
Epstein ML, Goldberg SJ, Allen HD, Konecke L, Wood J (1975) Great vessel, cardiac chamber, and wall growth patterns in normal children.Circulation 51:1124–1129
Felner JM, Blumenstein BA, Schlant RC, Carter AD, Alimurung BN, Johnson MJ, Sherman SW, Klicpera MW, Kutner MH, Drucker LW (1980) Sources of variability in echocardiographic measurements.Am J Cardiol 45:995–1004
Fortuin NJ, Hood WP, Sherman ME, Craige E (1971) Determination of left ventricular volumes by ultrasound.Circulation 44:575–584
Freidman MJ, Sahn DJ (1979) Computer-assisted analysis of m-mode echocardiograms: is it a “goldmine”?Pediatr Cardiol 1:47–50
Freidman MJ, Sahn DJ, Burris HA, Allen HD, Goldberg SJ (1979) Computerized echocardiographic analysis to detect abnormal systolic and diastolic left ventricular function in children with aortic stenosis.Am J Cardiol 44:478–486
Gutgesell HP, Paquet M, Duff DF, McNamara DG (1977) Evaluation of left ventricular size and function by echocardiography.Circulation 56:457–462
Hagan AD, Deely WJ, Sahn D, Friedman WF (1973) Echocardiographic criteria for normal newborn infants.Circulation 47:1221–1226
Hofstetter R, Mayr A, Von Bernuth G (1982) Computer analysis of cardiac contractility variables obtained by M-mode echocardiography in normal newborns.Br Heart J 48:525–528
Kugler JD, Gutgesell HP, Nihill MR (1979) Instantaneous rates of left ventricular wall motion in infants and children: computer-assisted determination from single-cycle echocardiograms.Pediatr Cardiol 1:15–29
Kupari M (1984) Reproducibility of M-mode echocardiographic assessment of left ventricular function: significance of the temporal range of measurements.Eur Heart J 5:412–418
Ladipo GOA, Dunn FG, Pringle TH, Bastian B, Lawrie TDV (1980) Serial measurements of left ventricular dimensions by echocardiography.Br Heart J 44:284–289
MacMahon SW, Hickey AJ, Wilcken DEL (1983) M-mode echocardiography: reproducibility of serial left ventricular measurements in subjects with normal ventricles and patients with congestive cardiomyopathy.Aust NZ J Med 13:457–462
Meyer RA (1977) Pediatric echocardiography. Lea and Febiger, Philadelphia, p 294
Monoson PA, O'Rourke RA, Crawford MH, White DH (1978) Measurements of left ventricular wall thickness and systolic thickening by m-mode echocardiography: interobserver and intrapatient variability.J Clin Ultrasound 6:252–258
Murray JA, Johnston W, Reid JM (1972) Echocardiographic determination of left ventricular dimensions, volumes and performance.Am J Cardiol 30:252–257
Pollick CH, Fitzgerald PJ, Popp RL (1983) Variability of digitized echocardiography: size, source, and means of reduction.Am J Cardiol 51:576–582
Pombo JF, Troy BL, Russell RO (1971) Left ventricular volumes and ejection fraction by echocardiography. Circulation 42:480–490
Popp RL, Wolfe SB, Hirata T, Feigenbau H (1969) Estimation of right and left ventricular size by ultrasound.Am J Cardiol 24:523–530
Sahn DJ, De Maria A, Kisslo J, Weyman A (1978) Recommendations regarding quantitation in m-mode echocardiography: results of a survey of echocardiographic measurements.Circulation 58:1072–1083
Schumacher PM (1986) Components of variability in digitized m-mode echocardiography. MSc thesis, University of British Columbia, Vancouver BC
Statistical Analysis Systems (SAS) Instruments. Cary NC (1982)
St. John Sutton MG, Hagler DJ, Tajik AJ, Giuliani ER, Seward JB, Ritter GG, Ritman EL (1978) Cardiac function in the normal newborn: additional information by computer analysis of the m-mode echocardiogram.Circulation 57:1198–1204
St. John Sutton MG, Marier DL, Oldershaw PJ, Sacchetti R, Gibson DG (1982) Effect of age related changes in chamber size, wall thickness, and heart rate on left ventricular function in normal children.Br Heart J 48:342–351
Unverferth DV, Lewis RP, Leier CV, Magorien RD, Fulkerson PK (1980) Reproducibility of echocardiography in chronic congestive heart failure.J Clin Ultrasound 8:479–482
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Sandor, G.G.S., Schumacher, P., Puterman, M.L. et al. Normal serial variability for M-mode and digitized echocardiography in a pediatric population. Pediatr Cardiol 8, 23–26 (1987). https://doi.org/10.1007/BF02308380
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DOI: https://doi.org/10.1007/BF02308380