Comparison of ejection phase indices of left ventricular performance in infants and children

Ejection phase indices of left ventricular myocardial performance, mean velocity of circumferential fiber shortening (mVcf), mean systolic ejection rate (mSER), and ejection fraction (EF) were determined in 248 pediatric patients, utilizing left ventricular projections of cineangiograms. Heart rate significantly affected mVcf and mSER values in the normal group (r=0.74, 0.79, respectively). A method for heart rate compensation was presented, utilizing a ratio of actual value to expected normal value (A/E) for that heart rate. All indices were significantly lower in the myocardial disease group (12 patients) than in the normal (NI) group (55 patients), but only mVcf (A/E) gave complete separation. There was complete or nearly complete overlap of right ventricular volume and pressure load and left ventricular (LV) pressure load groups (20, 38, and 28 patients each) with NI. For LV volume load (95 patients) mVcf, and mVcf (A/E) mean values were low (P less than 0.025, less than 0.001, resp.). Patients with patent ductus arteriosus had high mVcf and mSER values (P less than 0.05, less than 0.025). MVcf (A/E) was superior to the other indices in identifying patients with depressed myocardial performance.