Real-time three-dimensional echocardiographic left heart parameters in healthy indian adults

Abstract

Objective Cardiac chamber dimensions are race and anthropometry dependent. We determined the age and gender specific 3-Dimensional echocardiographic (3DE) reference values for dimensions and function of left ventricle (LV) and left atrium (LA) in normal Indian adults. Methods This single center prospective study enrolled 133 adult Indians free of heart disease and/or hypertensions, subjecting them to 3DE measurements of left atrial (LA) & left ventricular (LV) volumes, function and left ventricular mass (LVM). The higher limits of normal cut-offs were determined for these parameters and their dependency on age, gender and anthropometry were analyzed. Results The body surface area (BSA) corrected higher limit cut-offs were: 59.37 ml/m 2 for LV end diastolic volume (59.19 ml/m 2 and 59.61 ml/m 2 for men and women, respectively; P = NS); 23.48 ml/m 2 for LV end systolic volume (23.27 ml/m2 and 23.11 ml/m 2 for men and women, P = NS). Mean LVEF was 64.79% ± 7.26 (62.99% ± 6.51 and 67.05% ± 7.58 in men and women, P = NS). Men had higher LVM than women (119.79 g±23.95 vs. 103.26 g±23.76, P < 0.001), this difference disappeared after BSA indexing. The higher limit cut-offs for normal LA volumes were 20.49 ml for minimum volume (21.18 ml and 19.46 ml for men and women, P = NS) and 39.76 ml for maximum volume (39.60 ml and 40.03 ml in men and women, P = NS). The parameters were smaller compared to western populations but the differences attenuated after BSA indexing. Conclusions The study reports normal 3DE parameters of size and function of left heart chambers in Indians.

Standardization of normal values for cardiac chamber size in echocardiography

“…The preliminary reports from the WASE study support these results [33,34]. The upper limit of normal (ULN) for 3D LV volumes were found to be lower for Japanese and Indian Asians than for Europeans [26,[29][30][31]. However, for these studies, 3D LV volume datasets were acquired with apparatus from different vendors, and LV volumes were analyzed using a variety of software.…”

“…Recently, the WASE Normal Values study used a uniformed measurement protocol to examine in two core laboratories data for over 2000 normal subjects enrolled worldwide, and found only minor differences for LV size among races and countries, although the normal reference values recommended in the current guidelines need to be adjusted [15]. Regarding 3DE, the current guidelines recommend normal values for 3D LV volumes on the basis of three studies published a decade ago [24][25][26], although several studies have reported that normal reference values for LV volumes were different in a variety of countries and regions [27][28][29][30][31][32] (Table 1). According to most of these publications, 3D LV volumes were larger than 2D LV volumes, as well as larger for males than for females even after indexing to BSA, while they decreased with age for both genders.…”

Normal reference values of left atrial volumes and volume‐based functional properties using three‐dimensional speckle‐tracking echocardiography in healthy adults (Insights from the MAGYAR‐Healthy Study)

“…AASV, Active atrial stroke volume; PASV, Passive atrial stroke volume; TASV, Total atrial stroke volume shape. 10,11 Normal 3D echocardiographic LA volumetric variables have been demonstrated in adults 12,13 and in elderly subjects. 13,14 These variables were also defined in children by 3D echocardiography using a commercial speckle-tracking package.…”

“…10,11 Normal 3D echocardiographic LA volumetric variables have been demonstrated in adults 12,13 and in elderly subjects. 13,14 These variables were also defined in children by 3D echocardiography using a commercial speckle-tracking package. 15 The 3DSTE technique takes one step forward: by using created virtual 3D cast, not only volumetric but also strain data can be measured at the same time.…”

“…Real‐time 3D echocardiography (RT3DE) sees the LA as it is, that is, a 3D organ with an almost always atypical shape 10,11 . Normal 3D echocardiographic LA volumetric variables have been demonstrated in adults 12,13 and in elderly subjects 13,14 . These variables were also defined in children by 3D echocardiography using a commercial speckle‐tracking package 15 .…”