KUMJ | VOL. 24 | NO. 3 | ISSUE 96 | JULY-SEPTEMBER, 2026

Echocardiographic Measurements of Cardiac Structures and Systolic Function in Healthy Nepalese Neonates
Joshi A, Pathak S, Poudel P, Aryal R, Sapkota V

Abstract:
Background Echocardiography is being used routinely to evaluate neonates with suspected heart disease. “To detect changes in the structure and function, in heart diseases, it is important to precisely ascertain the normal growth and development on echocardiographic parameters of chamber size, thickness, and function based on local evidence.” However, locally established reference values for Nepalese neonates are limited Objective To establish reference echocardiographic measurements of cardiac structures and systolic function in healthy Nepalese neonates. Method This prospective observational study included 559 normal neonates ranging from 2 to 7 days of life using 2D and M-mode echocardiography over the period of 18 months, from September 1st 2018 to February 28th 2020. The echocardiographic measurements of the following structures were reviewed (1) LVend-diastolic,endsystolic diameters, interventricular wall thickness, LV posterior wall thickness, Aorta (systolic) and Left atrium (diastolic) using M-mode imaging; (2) the mitral valve annulus evaluated in the apical four-chamber view and parasternal long-axis view and the tricuspid valve annulus evaluated in the apical four chamber view; (3) diameters of pulmonary annulus, main pulmonary artery, and branch pulmonary arteries measured in the parasternal short-axis view; (4) diameters of the aortic annulus evaluated in the parasternal long-axis view. Result A total of 559 neonates were included in the study, comprising 287 (51.3%) males and 272 (48.7%) females. The mean gestational age was 38.03 ± 1.76 weeks, and the mean birth weight was 2.90 ± 0.67 kg. Echocardiographic assessment demonstrated a mean mitral valve annulus diameter of 11.39 ± 1.70 mm and a mean tricuspid valve annulus diameter of 13.97 ± 1.88 mm. The mean aortic root diameter was 7.85 ± 1.21 mm, while the mean left atrial diameter was 11.61 ± 1.99 mm. The mean pulmonary valve annulus diameter and main pulmonary artery diameter were 8.34 ± 1.15 mm and 7.98 ± 1.10 mm, respectively. The mean left ventricular internal dimension was 17.11 ± 2.39 mm in diastole and 10.54 ± 1.66 mm in systole. Conclusion This study establishes echocardiographic reference values for healthy neonates in a tertiary care center in Nepal. These locally derived reference values may support accurate interpretation of neonatal echocardiography in routine clinical practice.
Keyword : Echocardiography, Infant, Measurement, Neonates, Term births