Echocardiographic reference ranges for normal cardiac chamber size: results from the NORRE study

Kou, Seisyou; Caballero, Luis; Dulgheru, Raluca; Voilliot, Damien; Sousa, Carla; Kacharava, George; Athanassopoulos, George; Barone, Daniele; Baroni, Monica; Cardim, Nuno; Diego, José Juan Gómez de; Hagendorff, Andreas; Henri, Christine; Hristová, Krasimira; López, Teresa; Magné, Julien; Morena, Gonzalo de la; Popescu, Bogdan A; Pěnička, Martin; Özyiğit, Tolga; Carbonero, D. Rodrigo; Salustri, Alessandro; Veire, Nico Van de; Bardeleben, Ralph Stephan von; Vinereanu, Dragoş; Voigt, Jens‐Uwe; Zamorano, José Luís; Donal, Erwan; Lang, Roberto M.; Badano, Luigi P.; Lancellotti, Patrizio

doi:10.1093/ehjci/jet284

Cited by 347 publications

(356 citation statements)

References 25 publications

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“…Cardiac output indexed to BSA was higher among Indigenous and European-descent adults in the present study compared to normally active adults [27]. When indexed to surface area, the present study measures of systolic LV internal diameter are similar to published normative data, though sex differences were not identified among either ethnicity in this investigation [34]. Compared to published normal values, end systolic and diastolic values indexed for BSA among the present investigation were greater and sex differences were only identified among European-descent adults in the present investigation [35].…”

Section: Discussionsupporting

confidence: 71%

“…Among published literature, only LV mass has been evaluated relative to BSA among Indigenous adults, while LV mass, systolic LV internal diameter, end systolic and diastolic volumes, and cardiac output are reported relative to BSA among non-Indigenous adults [27,34,35]. In comparison to Indigenous populations previously evaluated, LV mass was smaller among women participants in the current investigation, even after indexing for BSA and comparing to non-obese women [32].…”

Section: Discussionmentioning

confidence: 86%

“…Sex differences identified among Indigenous adults are consistent with previous findings among Indigenous and/or young, healthy adults, with differences in LV mass, arterial elastance, arterial impedance and stroke volume [27,32,33], and differences in LV mass and cardiac output are accounted for by differences in BSA [27]. More sex differences were identified among the European-descent adults, including LV mass indexed for body size, ventricular elastance, systolic LV internal diameter, end systolic and diastolic volumes, stroke volume, fractional shortening and rotation, consistent with normal values [34,35]. Previously identified sex differences in ejection fraction [8,31], relative wall thicknesses, peak E and A velocities, and E/A ratio [32] may not have been identified in the current investigation, among either ethnic group, likely due to a small sample size.…”

Section: Discussionmentioning

confidence: 97%

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Cardiovascular dynamics of Canadian Indigenous peoples

Foulds

Bredin

2018

International Journal of Circumpolar Health

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Limited understanding of Indigenous adults’ cardiovascular structure and function exists despite high rates of cardiovascular disease. This investigation characterised cardiovascular structure and function among young Indigenous adults and compared to age- and sex-matched European descendants. Echocardiographic assessments included apical two- and four-chamber images, parasternal short-axis images and Doppler. Analyses included cardiac volumes, dimensions, velocities and strains. Cardiovascular structure and function were similar between Indigenous (n=10, 25 ± 3 years, 4 women) and European-descendant (n=10, 24 ± 4 years, 4 women,) adults, though European descendants demonstrated greater systemic vascular resistance (18.19 ± 3.94 mmHg∙min−1∙L−1 vs. 15.36 ± 2.97 mmHg∙min−1∙L−1, p=0.03). Among Indigenous adults, women demonstrated greater arterial elastance (0.80 ± 0.15 mmHg·mL−1·m−2 vs. 0.55 ± 0.17 mmHg·mL−1·m−2, p=0.02) and possibly greater systemic vascular resistance (17.51 ± 2.20 mmHg∙min−1∙L−1 vs. 13.93 ± 2.61 mmHg∙min−1∙L−1, p=0.07). Indigenous men had greater cardiac size, dimensions and output, though body size differences accounted for cardiac size differences. Similar cardiac rotation and strains were observed across sexes. Arterial elastance and cardiac size were different between Indigenous men and women while cardiovascular structure and function may be similar between Indigenous and European descendants.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 97%

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Cardiovascular dynamics of Canadian Indigenous peoples

Foulds

Bredin

2018

International Journal of Circumpolar Health

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“…However, the clinical utility of EDA and EDD for intra-operative decisions and prognosis depends on the accuracy and reliability of normal values. In fact, the availability of normative reference values for cardiac chamber quantification is a prerequisite for accurate clinical application of echocardiography (6). Two large studies recently published normal values as assessed using transthoracic echocardiography (TTE) in young and healthy patients (6,7).…”

Section: Introductionmentioning

confidence: 99%

“…In fact, the availability of normative reference values for cardiac chamber quantification is a prerequisite for accurate clinical application of echocardiography (6). Two large studies recently published normal values as assessed using transthoracic echocardiography (TTE) in young and healthy patients (6,7). However, such values might not necessarily apply for patients with coronary heart disease.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Left Ventricular Dimensions by Transoesophageal Echocardiography in Patients During Coronary Artery Bypass Surgery

Bolliger¹,

Poltera²,

Cheung³

et al. 2018

Turk J Anaesth Reanim

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Objective: Normative values for left ventricular (LV) end-diastolic area (EDA) and diameter (EDD) for intra-operative transoesophageal echocardiography (TOE) have not been established. We aimed to define the ranges of LV EDA and EDD for intra-operative TOE examinations in patients undergoing coronary artery bypass graft (CABG) surgery. Methods: A MEDLINE search for studies reporting LV EDA and EDD in patients undergoing CABG surgery was performed. Individual-level data set from 333 anaesthetised and ventilated patients with preserved LV function (study population) was obtained from eight studies. EDA and calculated EDD in the study population were compared with summary EDD values obtained using transthoracic echocardiography (TTE) in two studies of 500 awake patients with coronary artery disease (CAD). Further, the influence of pre-specified factors on EDD was evaluated in a multivariate regression model. Results: The EDA and EDD values measured using TOE in the anaesthetised CABG patients were 16.7±4.7 cm 2 and 4.6±0.6 cm, respectively. TOE values of EDD in anaesthetised patients were 10%-13% less than those measured using TTE in two studies of awake patients (p<0.001). Body surface area, age and fractional area change, but not sex were factors that affected LV EDD. Conclusion:The values for LV EDD measured through intra-operative TOE in anaesthetised ventilated CABG patients were 10%-13% less than the corresponding values measured using TTE in awake CAD patients. This finding indicates that independent normative values specific for intra-operative TE should be established for guiding intra-operative clinical decisions. Keywords: Echocardiography, transthoracic echocardiography, transesophageal echocardiography, cross-sectional, coronary artery bypass surgery Amaç: İntraoperatif transözofajiyal ekokardiyografi (TOE) için sol ventrikül (SV) diyastol sonu alanı (EDA) ve çapının (EDD) normal değerleri belirlenmemiştir. Bu çalışmanın amacı, koroner arter bypass greft (KABG) ameliyatı geçiren hastalarda yapılan intraoperatif TOE incelemeleri için SV EDA ve EDD aralıklarını tanımlamaktır. Yöntemler: KABG ameliyatı geçiren hastalarda SV EDA ve EDD değerlerini rapor eden çalışmalar için bir MEDLINE araştırması yapıldı. Korunmuş SV fonksiyonu olan 333 anestezi ve ventilasyon uygulanmış hastanın (çalışma popülasyonu) bireysel verileri 8 çalışmadan elde edildi. Çalışma popülasyonundaki EDA ve hesaplanmış EDD değerleri, koroner arter hastalığı (KAH) olan 500 bilinçli hastayı içeren iki çalışmada transtorasik ekokardiyografi (TTE) kullanarak elde edilen özet EDD değerleri ile karşılaştırıl-dı. Ayrıca, önceden belirlenmiş faktörlerin EDD üzerindeki etkisi multivaryant regresyon modeli kullanılarak değerlendirildi. Bulgular: Anestezi altındaki KABG hastalarında TOE kullanılarak ölçülen EDA ve EDD değerleri sırasıyla 16,7±4,7 cm 2 ve 4,6±0,6 cm olarak bulundu. Anestezi uygulanan hastalarda TOE ve EDD değerleri, bilinçli hastalar üzerinde yapılan iki çalışmada TTE kullanılarak ölçülen değerlere göre %10-%13 daha düşüktü (p<0,00...

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Association of Left Ventricular Systolic Function With Incident Heart Failure in Late Life

et al. 2021

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IMPORTANCE Limited data exist regarding the association of subtle subclinical systolic dysfunction and incident heart failure (HF) in late life.OBJECTIVE To assess the independent associations of subclinical impairments in systolic performance with incident HF in late life. DESIGN, SETTING, AND PARTICIPANTSThis study was a time-to-event analysis of participants without heart failure in the Atherosclerosis Risk in Communities (ARIC) study, a prospective, community-based cohort study, who underwent protocol echocardiography at the fifth study visit (January 1, 2011, to December 31, 2013. Findings were validated independently in participants in the Copenhagen City Heart Study (CCHS). Data analysis was performed from June 1, 2018, to February 28, 2020.EXPOSURES Left ventricular ejection fraction (LVEF), longitudinal strain (LS), and circumferential strain (CS) measured by 2-dimensional and strain echocardiography.MAIN OUTCOMES AND MEASURES Main outcomes were incident adjudicated HF and HF with preserved and reduced LVEF at a median follow-up of 5.5 years (interquartile range, 5.0-5.8 years). Cox proportional hazards regression models adjusted for demographics, hypertension, diabetes, obesity, smoking, coronary disease, estimated glomerular filtration rate, LV mass index, e′, E/e′, and left atrial volume index. Lower 10th percentile limits were determined in 374 participants free of cardiovascular disease or risk factors. RESULTS Among 4960 ARIC participants (mean [SD] age, 75 [5] years; 2933 [59.0%] female; 965 [19%] Black), LVEF was less than 50% in only 76 (1.5%). In the 3552 participants with complete assessment of LVEF, LS, and CS, 983 (27.7%) had 1 or more of the following findings: LVEF less than 60%, LS less than 16.0%, or CS less than 23.7%. Modeled continuously or dichotomized, worse LVEF, LS, and CS were each independently associated with incident HF. The adjusted hazard ratio (HR) per SD decrease in LVEF was 1.41 (95% CI, 1.29-1.55); the HR for LVEF less than 60% was 2.59 (95% CI, 1.99-3.37). Similar findings were observed for continuous LS (HR, 1.37; 95% CI, 1.22-1.53) and dichotomized LS (HR, 1.93; 95% CI, 1.46-2.55) and for continuous CS (HR, 1.39; 95% CI, 1.22-1.57) and dichotomized CS (HR, 2.30; 95% CI, 1.64-3.22). Although the magnitude of risk for incident HF or death associated with impaired LVEF was greater using guideline (HR, 2.99; 95% CI, 2.19-4.09) compared with ARIC-based limits (HR, 1.88; 95% CI, 1.58-2.25), the number of participants classified as impaired was less (104 [2.1%] based on guideline thresholds compared with 692 [13.9%] based on LVEF <60%). The population-attributable risk associated with LVEF less than 60% was 11% compared with 5% using guideline-based limits, a finding replicated in 908 participants in the CCHS.CONCLUSIONS AND RELEVANCE These findings suggest that relatively subtle impairments of systolic function (detected based on LVEF or strain) are independently associated with incident HF and HF with reduced LVEF in late life. Current recommended assessments of LV functio...

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Echocardiographic reference ranges for normal cardiac chamber size: results from the NORRE study

Cited by 347 publications

References 25 publications

Cardiovascular dynamics of Canadian Indigenous peoples

Cardiovascular dynamics of Canadian Indigenous peoples

Assessment of Left Ventricular Dimensions by Transoesophageal Echocardiography in Patients During Coronary Artery Bypass Surgery

Association of Left Ventricular Systolic Function With Incident Heart Failure in Late Life

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