Echocardiographic Assessment of Increased Left Ventricular Wall Thickness in School-Age Children and Adolescents

Masao Yoshinaga; Eiki Nishihara; Tadayoshi Hata; Katsumi Abe; Kunio Ohta; Sigeru Tateno; Yuichi Nomura; Hitoshi Horigome; Keiichi Hirono; Mari Iwamoto; Daisuke Hazeki; Seiichi Sato; Yumiko Ninomiya; Yuji Tanaka; Kenji Kuraishi; Kazuyoshi Saito; Naomi Izumida; Hidenori Iwasaki; Fumie Takechi; Shouji Matsushima; Hiroyuki Tsutsui; Hiromitsu Ogata; Hideto Takahashi; Nobuo Tauchi; Masami Nagashima

doi:10.24509/jpccs.24-004

Echocardiographic Assessment of Increased Left Ventricular Wall Thickness in School-Age Children and Adolescents

Masao Yoshinaga

^1,2，Eiki Nishihara³，Tadayoshi Hata⁴，Katsumi Abe⁵，Kunio Ohta⁶，Sigeru Tateno⁷，Yuichi Nomura⁸，Hitoshi Horigome⁹，Keiichi Hirono¹⁰，Mari Iwamoto¹¹，Daisuke Hazeki¹²，Seiichi Sato¹³，Yumiko Ninomiya¹，Yuji Tanaka¹，Kenji Kuraishi³，Kazuyoshi Saito⁴，Naomi Izumida¹⁴，Hidenori Iwasaki⁶，Fumie Takechi^15,16，Shouji Matsushima¹⁷，Hiroyuki Tsutsui^17,18，Hiromitsu Ogata¹⁹，Hideto Takahashi²⁰，Nobuo Tauchi²¹，Masami Nagashima²¹Masao Yoshinaga

^1,2, Eiki Nishihara³, Tadayoshi Hata⁴, Katsumi Abe⁵, Kunio Ohta⁶, Sigeru Tateno⁷, Yuichi Nomura⁸, Hitoshi Horigome⁹, Keiichi Hirono¹⁰, Mari Iwamoto¹¹, Daisuke Hazeki¹², Seiichi Sato¹³, Yumiko Ninomiya¹, Yuji Tanaka¹, Kenji Kuraishi³, Kazuyoshi Saito⁴, Naomi Izumida¹⁴, Hidenori Iwasaki⁶, Fumie Takechi^15,16, Shouji Matsushima¹⁷, Hiroyuki Tsutsui^17,18, Hiromitsu Ogata¹⁹, Hideto Takahashi²⁰, Nobuo Tauchi²¹, Masami Nagashima²¹

¹ Department of Pediatrics, NHO Kagoshima Medical Center ◇ Kagoshima, Japan

² Orange Medical and Welfare Center for Severe Motor and Intellectual Disabilities ◇ Kagoshima, Japan

³ Department of Pediatric Cardiology and Neonatology, Ogaki Municipal Hospital ◇ Gifu, Japan

⁴ Department of Pediatrics, Fujita Health University School of Medicine ◇ Aichi, Japan

⁵ Tokyo Health Service Association ◇ Tokyo, Japan

⁶ Department of Medical Education, Kanazawa University ◇ Kanazawa, Japan

⁷ Department of Pediatrics, Chiba Kaihin Municipal Hospital ◇ Chiba, Japan

⁸ Department of Pediatrics, Kagoshima City Hospital ◇ Kagoshima, Japan

⁹ Department of Pediatric Cardiology, Ibaraki Children’s Hospital ◇ Ibaraki, Japan

¹⁰ Department of Pediatrics, Faculty of Medicine, University of Toyama ◇ Toyama, Japan

¹¹ Children’s Center, Saiseikai Yokohamashi Tobu Hospital ◇ Kanagawa, Japan

¹² Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences ◇ Kagoshima, Japan

¹³ Department of Pediatric Cardiology, Okinawa Prefectural Nanbu Medical Center & Children’s Medical Center ◇ Okinawa, Japan

¹⁴ Pediatric Cardiology, Akebonocho Clinic ◇ Tokyo, Japan

¹⁵ Department of Pediatrics, Chiba Cardiovascular Center ◇ Chiba, Japan

¹⁶ Department of Pediatrics, Graduate School of Medical and Pharmaceutical Sciences, Chiba University ◇ Chiba, Japan

¹⁷ Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University ◇ Fukuoka, Japan

¹⁸ School of Medicine and Graduate School, International University of Health and Welfare ◇ Fukuoka, Japan

¹⁹ Graduate School of Kagawa Nutrition University ◇ Saitama, Japan

²⁰ Faculty of Graduate School of Information Sciences, Teikyo Heisei University ◇ Tokyo, Japan

²¹ Aichi Saiseikai Rehabilitation Hospital ◇ Aichi, Japan

受付日：2024年2月29日Received: February 29, 2024

受理日：2024年11月25日Accepted: November 25, 2024

発行日：2025年7月31日Published: July 31, 2025

Background: Echocardiographic assessment of increased left ventricular wall thickness (LVWT) is still undetermined in children and adolescents.

Methods: LVWT was measured by interventricular septal thickness [IVST] and left ventricular posterior wall thickness [PWT] in 579 school-age healthy volunteers (293 males and 286 females) at 11 hospitals in Japan. LVWT was adjusted by body surface area (BSA): (adjusted LVWT value)=(measured LVWT)/(BSA)^α, where α is a parameter of the exponent. Three different BSA formulae (Haycock’s, DuBois’, and Fujimoto’s formulae) were used. To create cut-off points for increased LVWT to predict whether myocardial hypertrophy would progress in the future, the estimated prevalence of childhood hypertrophic cardiomyopathy was taken into consideration.

Results: The exponents α in the exponential models to adjust LVWT for BSA were 0.398 in boys and 0.445 in girls for IVST, and 0.470 in boys and 0.479 in girls for PWT when Haycock’s formula was used. The adjusted IVST and PWT values by BSA^α were normally distributed in both sexes. Tentative cut-offs for increased adjusted LVWT were 9.0 mm for all three grades in males and 8.4 and 8.8 mm for the 1st and the 7th/10th grade females, respectively. Tentative cut-offs for increased measured (unadjusted) LVWT were 8.5, 10.5, and 11.5 mm for the 1st, the 7th, and the 10th grade males and 8.0 and 10.5 mm for the 1st, and the 7th/10th grade females, respectively.

Conclusion: These tentative echocardiographic values help with the early assessment of increased LVWT in school-age children and adolescents and might help with early assessment of myocardial hypertrophy potentially present.

Key words: assessment; echocardiography; hypertrophic cardiomyopathy; school-age; wall thickness

Journal of Pediatric Cardiology and Cardiac Surgery

Original ArticleOriginal Article

Echocardiographic Assessment of Increased Left Ventricular Wall Thickness in School-Age Children and Adolescents