Normal Echocardiographic Measurements in a Korean Population Study: Part II. Doppler and Tissue Doppler Imaging

Abstract

BackgroundHemodynamic and functional evaluation with Doppler and tissue Doppler study as a part of comprehensive echocardiography is essential but normal reference values have never been reported from Korean normal population especially according to age and sex.MethodsUsing Normal echOcaRdiographic Measurements in a KoreAn popuLation study subjects, we obtained normal reference values for Doppler and tissue Doppler echocardiography including tricuspid annular velocities according to current guidelines and compared values according to gender and age groups.ResultsMitral early diastolic (E) and late diastolic (A) velocity as well as E/A ratio were significantly higher in women compared to those in men. Conversely, mitral peak systolic and late diastolic annular velocity in both septal and lateral mitral annulus were significantly lower in women compared to those in men. However, there were no significant differences in both septal and lateral mitral early diastolic annular (e') velocity between men and women. In both men and women, mitral E velocity and its deceleration time as well as both E/A and E/e' ratio considerably increased with age. There were no significant differences in tricuspid inflow velocities and tricuspid lateral annular velocities between men and women except e' velocity, which was significantly higher in women compared to that in men. However, changes in both tricuspid inflow and lateral annular velocities according to age were similar to those in mitral velocities.ConclusionSince there were significant differences in Doppler and tissue Doppler echocardiographic variables between men and women and changes according to age were even more considerable in both gender groups, normal Doppler echocardiographic values should be differentially applied based on age and sex.

Adult echocardiographic nomograms: overview, critical review and creation of a software for automatic, fast and easy calculation of normal values

“…Our research highlighted how there was sufficient agreement on criteria of inclusion adopted by latest major studies ( 1 5 -2 3 , 3 8 , 5 1 , 5 2 , 6 3 ) . H y p e r l i p i d e m i a , s y s t e m i c hypertension, diabetes mellitus, lung disease, renal failure, liver failure, genetic syndrome, neuro-muscular disorders, abnormal electrocardiographic and/or echocardiographic findings, connective tissue disease, and poor image quality have been used as exclusion criteria in the majority of works (15)(16)(17)(18)(19)(20)(21)(22)(23)38,51,52,63). Pregnant or lactating women, athletes, and subjects addicted to alcohol were also excluded by a few authors (15,16,60), and some studies also evaluated smoking (15,21,38,82), anaemia and fever (15,16) as exclusion criteria.…”

“…Pregnant or lactating women, athletes, and subjects addicted to alcohol were also excluded by a few authors (15,16,60), and some studies also evaluated smoking (15,21,38,82), anaemia and fever (15,16) as exclusion criteria. However, in some studies (15,19,38,43,52,54,63,82), inclusion criteria were well defined, in other sufficiently explained (20,21,24,30,50,52,61,67,70,74,76), while in few works the criteria were more generic (23,24,26,58,59,69,73).…”

“…Almost all studies presented data as mean values (plus or minus standard deviation) normalised by gender, age groups and at times indexed by body surface area (BSA) (15)(16)(17)(18)(19)(20)(21)(22)(23)(34)(35)(36)38,50,58,59,61,90,91). A few studies used percentile (35,72,(76)(77)(78)80) and one study employed z scores (41) that are commonly used in the pediatric age group.…”

“…Differences among age groups and gender have been widely studied (15)(16)(17)(20)(21)(22)(23). Influence of body size parameters (i.e., weight, height and body size) has been evaluated only in a few studies (50,81,82).…”

“…Over the last few years , there has been a crescent call for patients specific rather than generic threshold values , leading multiple authors to publish echocardiographic normative data . In particular, four major multi-center studies (the Normal Reference Range for Echocardiography-NORRE-European, The Japanese Normal Values for Echocardiographic Measurement Project-JAMP, The Echocardiographic Measurements in Normal Chinese Adults-Eminca, and The Normal Echocardiographic Measurements in a Korean population-NORMAL-trials) are currently ongoing and normative data for many 2D and a few 3D parameters have been published (15)(16)(17)(18)(19)(20)(21)(22)(23)52). Contemporary, different centers addressed the need of having normative data for new parameters coming from 3D echocardiography (45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58) and deformation analysis .…”