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Year : 2021  |  Volume : 7  |  Issue : 1  |  Page : 85

A neonatal echocardiographic Z-score nomogram for a developing Country

Professor in Paediatrics and Child Health, Consultant Paediatrician, Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Submission03-Jan-2021
Date of Decision16-Jan-2021
Date of Acceptance10-Feb-2021
Date of Web Publication24-Apr-2021

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpcs.jpcs_2_21

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How to cite this article:
Al-Mendalawi MD. A neonatal echocardiographic Z-score nomogram for a developing Country. J Pract Cardiovasc Sci 2021;7:85

How to cite this URL:
Al-Mendalawi MD. A neonatal echocardiographic Z-score nomogram for a developing Country. J Pract Cardiovasc Sci [serial online] 2021 [cited 2023 May 28];7:85. Available from: https://www.j-pcs.org/text.asp?2021/7/1/85/314474


I read the interesting article by Jain et al.[1] published in September–December 2020 issue of the Journal of the Practice of Cardiovascular Sciences. Using two-dimensional and M mode echocardiography, Jain et al.[1] formulated the echocardiographic data of various routinely measured cardiovascular structures in Indian newborns up to 24 h after birth and derived Z-score graphs for those components. Apart from the few study limitations addressed by Jain et al.,[1] I presume that the following methodological limitation is also contributory. Ethnicity is an important determinant of generating nomograms of different pediatric echocardiographic measurements.[2],[3],[4] India is a well-known and diverse multiethnic country that is the home to thousands of small ethnic and tribal groups.[5] Regrettably, Jain et al.[1] did not state the exact ethnic standard of the studied population. We realize that it is a major challenge to practically establish a research methodology on the neonatal echocardiographic Z-scores of the different cardiovascular structures related to a particular ethnicity in a multiethnic population such as India. Nevertheless, the effect of ethnic diversity must be taken into consideration during assessing the clinical applicability of the nomogram constructed by Jain et al.[1]

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  References Top

Jain R, Mathew C, Rawal J, Shah T, Padhi B, Saxena N. A neonatal echocardiographic Z-score nomogram for a developing country. J Pract Cardiovasc Sci 2020;6:244-52.  Back to cited text no. 1
  [Full text]  
Lopez L, Colan S, Stylianou M, Granger S, Trachtenberg F, Frommelt P, et al. Relationship of echocardiographic Z scores adjusted for body surface area to age, sex, race, and ethnicity: The Pediatric Heart Network Normal Echocardiogram Database. Circ Cardiovasc Imaging 2017;10:e006979.  Back to cited text no. 2
Majonga ED, Norrish G, Rehman AM, Kranzer K, Mujuru HA, Nathoo K, et al. Racial variation in echocardiographic reference ranges for left chamber dimensions in children and adolescents: A systematic review. Pediatr Cardiol 2018;39:859-68.  Back to cited text no. 3
Mendizábal B, Khoury P, Woo JG, Urbina EM. Racial differences in the influence of risk factors in childhood on left ventricular mass in young adulthood. J Pediatr 2020;217:152-7.  Back to cited text no. 4
Britannic. India, People, Ethnic Groups. Available from: https://www.britannica.com/place/India/People. [Last accessed on 2021 Jan 01].  Back to cited text no. 5


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