McClean, G, Wilson, MG, Riding, NR, Pieles, G, Watt, V, Adamuz, C, Shaw, A, Harkness, A, Johnson, A, George, KP and Oxborough, D (2023) A New Tool to Aid the Differential Diagnosis of Physiological Remodelling from Cardiac Pathology When Assessing Left Ventricle, Left Atrial and Aortic Structure and Function in Male Arab and Black Paediatric Athletes. Journal of cardiovascular development and disease, 10 (2). ISSN 2308-3425

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Abstract

Aim: To determine if published Z-scores for left ventricular (LV), left atrial (LA) and aortic structure as well as indices of LV function (Doppler and TDI) in paediatric athletes and non-athletes are appropriate for application in male Arab and black paediatric athletes. If inappropriate, we aim to provide new nomograms and Z-scores for clinical application.
Methods: 417 (297 Arab, 120 black) male paediatric (11-18 years) athletes, were evaluated by 2D echocardiography as per British Society of Echocardiography recommendations, and biological age (by radiological X-ray) assessment. Z-scores were tested by residual and correlation analysis together with visual inspection. New Z-scores involved allometric (a*BSA(b+c*chronological age)) and second-order polynomial (y=a*chronological age2+b*chronological age+c) equations for measures of cardiac size and indices of LV function, respectively.
Results: Residual linear regression, correlation analysis and visual inspection revealed published z-scores in white peri-pubertal footballers and paediatric non-athletes to be inappropriate for application in male Arab and black paediatric athletes. Residual linear regression revealed new Z-scores for measures of LV, LA and aortic root size to be independent of BSA, ethnicity, chronological and biological age. Residual linear regression revealed new Z-scores for measures of function to be independent of chronological age.
Conclusion: Our new z-scores may aid differential diagnosis of suspected pathology versus physiology remodelling, in cardiac screening of the Arab and black paediatric athlete. Nomograms are provided to assist the tracking of the paediatric athlete necessitating annual follow-up and Excel z-score calculation to facilitate use in day-to-day practice.

Item Type:	Article
Uncontrolled Keywords:	athlete’s heart; echocardiogram; ethnicity; paediatric; sudden cardiac death
Subjects:	Q Science > QP Physiology R Medicine > RC Internal medicine > RC1200 Sports Medicine G Geography. Anthropology. Recreation > GV Recreation Leisure > GV561 Sports
Divisions:	Sport & Exercise Sciences
Publisher:	MDPI AG
SWORD Depositor:	A Symplectic
Date Deposited:	27 Feb 2023 12:39
Last Modified:	27 Feb 2023 12:39
DOI or ID number:	10.3390/jcdd10020037
URI:	https://researchonline.ljmu.ac.uk/id/eprint/18960

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