Majonga, Edith D.Rehman, Andrea M.McHugh, GraceMujuru, Hilda A.Nathoo, KusumPatel, Mohammad S.Munyati, ShunguOdland, Jon OyvindKranzer, KatharinaKaski, Juan P.Ferrand, Rashida A.2017-11-202017-11-202017-12Majonga, E.D. et al. 2017, 'Echocardiographic reference ranges in older children and adolescents in sub-Saharan Africa', International Journal of Cardiology, vol. 248, pp. 409-413.0167-5273 (print)1874-1754 (online)10.1016/j.ijcard.2017.06.109http://hdl.handle.net/2263/63197BACKGROUND : Echocardiographic reference ranges are important to identify abnormalities of cardiac dimensions. Reference ranges for children in sub-Saharan Africa have not been established. The aim of this study was to establish echocardiographic z-score references for Black children in sub-Saharan Africa. METHODS : 282 healthy subjects aged 6–16 years (143 [51%] males)with no known history of cardiac diseasewere enrolled in the study in Harare, Zimbabwe between 2014 and 2016. Standard M-mode echocardiography was performed and nine cardiac chamber dimensions were obtained. Two non-linear statistical models (gamma weighted model and cubic polynomial model) were tested on the data and the best fitting model was used to calculate z-scores of these cardiac chamber measures. The reference ranges are presented on scatter plots against BSA. RESULTS : Normative data for the following cardiac measures were obtained and z-scores calculated: right ventricular diameter at end diastole (RVEDD); left ventricular diameter at end diastole (LVEDD) and systole (LVESD); interventricular septal wall thickness at end diastole (IVSd) and systole (IVSs); left ventricular posterior wall thickness at end diastole (LVPWd) and systole (LVPWs); left atrium diameter at end systole (LA) and tricuspid annular plane systolic excursion (TAPSE). Girls had higher values for BMI and heart rate than boys (p = 0.048 and p = 0.001, respectively). Mean interventricular septal and left ventricular posterior walls thickness was higher than published normal values in predominantly Caucasian populations. CONCLUSION : These are the first echocardiographic reference ranges for children from sub Saharan Africa and will allow accurate assessment of cardiac dimensions in clinical practice.en© 2017 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY license.EchocardiographyReference rangesZ-scoresChildrenAfricaAgeMassInfantsCardiac chamberZ-scoresBody sizeHeart diseaseReference valuesHealthy Turkish childrenPlane systolic excursionArticle