Intracardiac flow vortex analysis in healthy children: a multicenter pediatric study

Background

Intracardiac flow fluid dynamics analysis is an innovative color Doppler–based echocardiographic technique that enables a non-invasive assessment of myocardial performance and blood flow dynamics within the cardiac chambers. While its clinical applicability has been demonstrated in adults, pediatric reference data remain limited.

Aims

To define age-specific reference values for key intracardiac flow vortex-related parameters and energy fluctuation indices in healthy pediatric subjects

Methods

A total of 250 healthy subjects of pediatric age underwent transthoracic echocardiography followed by left ventricular fluid dynamic analysis using apical three-chamber views. Evaluated parameters included vortex area, length, depth and intensity; average kinetic energy; fluctuations of vorticity, kinetic energy and shear stress; and vectorial force (magnitude and angle). Subjects were stratified into three age groups (0–5, 6–12 and 13–18 years)

Results

Significant age-related differences were observed in vortex morphology across pediatric groups. Vortex area showed a progressive reduction with increasing age, decreasing from 27.17% (25.58–29.11%) in children aged 0–5 years to 24.65% (22.38–26.14%) in adolescents (p = 0.0089). A similar age-dependent trend was observed for vortex intensity, which significantly decreased across age groups (–30% [–33% to –26%] vs –25% [–29% to –22%], p = 0.0275).

Vortex length also differed significantly among age groups (p = 0.0402), whereas vortex depth did not show significant age-related variations (p = 0.232). No significant differences were observed across age groups for kinetic energy or for fluctuations in vorticity, kinetic energy and shear stress (all p > 0.05). Vectorial force magnitude and direction remained stable throughout childhood and adolescence.

Conclusions

This study provides age-specific reference intervals for key intracardiac flow vortex parameters in a cohort of healthy pediatric subjects. These data support the potential role of intracardiac fluid dynamic analysis as a complementary tool in the pediatric echocardiographic evaluation of ventricular function.