Normal Values of Cardiac Output and Stroke Volume According to Measurement Technique, Age, Sex, and Ethnicity: Results of the World Alliance of Societies of Echocardiography Study

Patel, Hena; Miyoshi, Tatsuya; Addetia, Karima; Henry, Michael P.; Citro, Rodolfo; Daimon, Masao; Fajardo, Pedro Gutiérrez; Kasliwal, Ravi R; Kirkpatrick, James N.; Monaghan, Mark; Muraru, Denisa; Ogunyankin, Kofo O.; Park, Seung Woo; Ronderos, Ricardo; Sadeghpour, Anita; Scalia, G.; Takeuchi, Masaaki; Tsang, Wendy; Tucay, Edwin S.; Rodrigues, Ana Clara Tude; Amuthan, Vivekanandan; Zhang, Yun; Schreckenberg, Marcus; Blankenhagen, Michael; Degel, Markus; Rossmanith, Alexander; Mor‐Avi, Victor; Asch, Federico M.; Lang, Roberto M.; Prado, Aldo; Filipini, Eduardo; Kwon, Agatha; Hoschke-Edwards, Samantha; Afonso, Tânia Regina; Thampinathan, Babitha; Sooriyakanthan, Maala; Tong, Zhu; Wang, Zhilong; Wang, Yingbin; Yin, Long; Li, Shuang; Alagesan, R; Balasubramanian, Sowmya; Ananth, R.V.A.; Bansal, Manish; Alizadehasl, Azin; Badano, Luigi P.; Bossone, Eduardo; Vece, Davide Di; Bellino, Michele; Nakao, Tomoko; Kawata, Takayuki; Hirokawa, Megumi; Sawada, Naruhiko; Nabeshima, Yousuke; Yun, Hae-Ran; Hwang, Jiwon

doi:10.1016/j.echo.2021.05.012

Cited by 40 publications

(30 citation statements)

References 22 publications

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“…Furthermore, our findings suggest a physiological impact of the aging process on MEE and MEEi (more evident), highlighting the need to adapt the normal reference values to age. This is consistent with previous results demonstrating that, in both genders, CO and SV tended to decrease with age [ 21 ]. Of note, the reduction in MEEi was related to an increase in LVM associated with aging.…”

Section: Discussionsupporting

confidence: 94%

Physiologic Range of Myocardial Mechano-Energetic Efficiency among Healthy Subjects: Impact of Gender and Age

Ferrara

Capone

Cademartiri

et al. 2022

JPM

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Background: Myocardial mechano-energetic efficiency (MEE) is the capability of the left ventricle (LV) to convert the chemical energy obtained from the cardiac oxidative metabolism into mechanical work. The aim of present study was to establish normal non-invasive MEE and MEEi reference values. Methods: In total, 1168 healthy subjects underwent physical examinations, clinical assessment, and standardized transthoracic echocardiographic (TTE) examination. MEE was obtained by TTE as the ratio between stroke volume (SV) and heart rate (HR): MEE = SV/HR [HR expressed in seconds (HR/60)]. Because MEE is highly related to left ventricular mass (LVM), MEE was then divided by LVM with the purpose of obtaining an estimate of energetic expenditure per unit of myocardial mass (i.e., indexed MEE, MEEi, mL/s/g). Results: The mean values of MEE and MEEi in the overall population were 61.09 ± 18.19 mL/s; 0.45 ± 0.14, respectively. In a multivariable analysis, gender, body surface area (BSA), diastolic blood pressure, left atrial volume indexed to BSA, E/e’ and tricuspid annular plane systolic excursion (TAPSE) were the independent variables associated with MEE, while age, gender, BSA and TAPSE were the independent variables associated with MEEi. Conclusions: The knowledge of age- and gender-based MEE and MEEi normal values may improve the global assessment of LV cardiac mechanics and serve as a reference to identify phenotypes at high risk of cardiovascular events.

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Section: Discussionsupporting

confidence: 94%

Physiologic Range of Myocardial Mechano-Energetic Efficiency among Healthy Subjects: Impact of Gender and Age

Ferrara

Capone

Cademartiri

et al. 2022

JPM

Self Cite

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“…Stroke volume (SV) was determined as left ventricular end-diastolic volume (LVEDV) minus left ventricular end-systolic volume (LVESV), while the product of SV and HR provided cardiac output (Q). It should be noted that 2D echocardiography intrinsically underestimates SV and Q due to the geometry of the heart ( Patel et al, 2021 ), yet its high temporal resolution and reliability is required to obtain precise images in a given cardiac cycle during exercise. The Fick equation was used to assess the effect of blood normalization on peak arteriovenous O 2 difference, a variable that was not directly measured but estimated by the ratio of VO 2p eak and Q peak .…”

Section: Methodsmentioning

confidence: 99%

Differences in Cardiac Output and Aerobic Capacity Between Sexes Are Explained by Blood Volume and Oxygen Carrying Capacity

et al. 2022

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Whether average sex differences in cardiorespiratory fitness can be mainly explained by blood inequalities in the healthy circulatory system remains unresolved. This study evaluated the contribution of blood volume (BV) and oxygen (O2) carrying capacity to the sex gap in cardiac and aerobic capacities in healthy young individuals. Healthy young women and men (n = 28, age range = 20–43 years) were matched by age and physical activity. Echocardiography, blood pressures, and O2 uptake were measured during incremental exercise. Left ventricular end-diastolic volume (LVEDV), stroke volume (SV), cardiac output (Q), peak O2 uptake (VO2peak), and BV were assessed with precise methods. The test was repeated in men after blood withdrawal and reduction of O2 carrying capacity, reaching women’s levels. Before blood normalization, exercise cardiac volumes and output (LVEDV, SV, Q) adjusted by body size and VO2peak (42 ± 9 vs. 50 ± 11 ml⋅min–1⋅kg–1, P < 0.05) were lower in women relative to men. Blood normalization abolished sex differences in cardiac volumes and output during exercise (P ≥ 0.100). Likewise, VO2peak was similar between women and men after blood normalization (42 ± 9 vs. 40 ± 8 ml⋅min–1⋅kg–1, P = 0.416). In conclusion, sex differences in cardiac output and aerobic capacity are not present in experimental conditions matching BV and O2 carrying capacity between healthy young women and men.

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“…18 A recent study reported that lower normal limits for SVi calculated by Doppler echocardiography for ages of 41-65 years were 24.6 mL/m 2 for men and 24.2 mL/ m 2 for women, which are significantly lower than the cutoff value for LFS (SVi <35 mL/ m 2 ). 32 Therefore, most participants in our study had their LVEDV, LVMI, and SVi within the reference values. 31…”

Section: Discussionmentioning

confidence: 94%

Echocardiographic Investigation of Low-Flow State in a Hispanic/Latino Population

Kozák

Swett³

et al. 2022

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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Normal Values of Cardiac Output and Stroke Volume According to Measurement Technique, Age, Sex, and Ethnicity: Results of the World Alliance of Societies of Echocardiography Study

Cited by 40 publications

References 22 publications

Physiologic Range of Myocardial Mechano-Energetic Efficiency among Healthy Subjects: Impact of Gender and Age

Physiologic Range of Myocardial Mechano-Energetic Efficiency among Healthy Subjects: Impact of Gender and Age

Differences in Cardiac Output and Aerobic Capacity Between Sexes Are Explained by Blood Volume and Oxygen Carrying Capacity

Echocardiographic Investigation of Low-Flow State in a Hispanic/Latino Population

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