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Byline: Neeti. Makhija, Amita. Sharma, Rohan. Magoon, Abhinav. Kumar Sir, Following a gun-shot trauma, a middle-aged male was conservatively managed for the resultant grade II hepatic injury only to eventually [...]

The left ventricular ejection fraction (LVEF) is the percentage of blood that is emptied from the left ventricle at the end of contraction. It can be measured by echocardiography, the use of sound waves to visualize internal structures such as the heart. There are several echocardiographic methods of LVEF determination, but most require off-line computer analysis and are time-consuming and inconvenient for the routine of a busy laboratory. This study compared seven echocardiographic methods of LVEF determination with the ejection fraction measured by angiography, a diagnostic method involving X-ray of blood vessels after injection of a radiopaque substance. The results show that subjective analysis of an echocardiographic videotape by an experienced cardiologist or echocardiographer provided the best estimation of left ventricular ejection fraction whereas the time-consuming and expensive computer techniques provided poor estimates. (Consumer Summary produced by Reliance Medical Information, Inc.)

OBJECTIVE. Epidemiologic studies have shown associations between impaired fetal growth and risk for coronary heart disease in adults. The underlying mechanisms are unknown. We investigated whether restricted intrauterine growth affects cardiac structure. METHODS. We performed echocardiography on 216 9-year-old children who were measured previously at birth. The diameter of the coronary left and right main branches was derived from the widest dimension; total coronary artery diameter was calculated by adding the diameters of the left and right coronary arteries. Aortic root diameter, left atrial diameter, left ventricular diameter, left ventricular outflow tract diameter, and left ventricular mass were measured. RESULTS. On average, children who had weighed less at birth had a smaller total coronary artery diameter, aortic root diameter, and left ventricular outflow tract diameter after adjustment for gender, gestational age, current height and weight, and maternal height and prepregnant weight. For each SD increase in birth weight, total coronary diameter rose by 0.10 mm, log aortic root diameter rose by 1.5%, and log left ventricular outflow tract diameter rose by 1.6%. CONCLUSION. Impaired fetal growth may have long-term effects on cardiac structure. This may help to explain why adults whose birth weight was low are at greater risk for coronary heart disease. KEY WORDS. cohort studies, echocardiography, epidemiology, fetal growth. PEDIATRICS 2006;117:e257-e261. URL: www.pediatrics.org/cgi/doi/10.1542/peds.2005-1325