Reference Values for and Determinants of Right Atrial Area in Healthy Adults by 2-Dimensional Echocardiography

Grünig, Ekkehard; Henn, Philipp; D’Andrea, Antonello; Claussen, Martin; Ehlken, Nicola; Maier, Felicitas; Naeije, Robert; Nagel, Christian; Prange, Felix; Weidenhammer, Johannes; Fischer, Christine; Bossone, Eduardo

doi:10.1161/circimaging.112.978031

Cited by 68 publications

(80 citation statements)

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“…Cross-sectional studies of competitive athletes have documented a high prevalence of cardiac chamber enlargement [1][2][3][4] and increased wall thickness 5,6 and more recently, longitudinal studies have begun to clarify the causal relationship between exercise training and myocardial adaptation. [7][8][9] Recreational athletes, a growing population that is commonly encountered in clinical practice, perform far less exercise volume and do so at lower training intensities than elite athletes.…”

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confidence: 99%

Myocardial Adaptations to Recreational Marathon Training Among Middle-Aged Men

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Isaacs

et al. 2015

Circ: Cardiovascular Imaging

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Myocardial Adaptations to Recreational Marathon Training Among Middle-Aged Men

Zilinski

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Isaacs

et al. 2015

Circ: Cardiovascular Imaging

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“…In the first screening study which was able to identify early PH using echocardiography and right heart catheterization, patients with manifest disease had a mean RV area of 19.3 ± 6.84 cm 2 (median 18.4; 16.6-19.8) compared to 15.0 ± 5.41 cm 2 (median 14.7; 12.0-17.4) in non-PH patients [35]. Due to the high variability of RV area, RA area cut-off values [8] might be even more useful for screening for PH. Compared to multiple tomographic imaging planes, the obtained values of the RV area appear to be more reliable than the assessment of RV sizes measuring only diameters or inferring the volume.…”

Section: Discussionmentioning

confidence: 99%

“…None of the control subjects suffered from cardiovascular structural or functional abnormalities or were receiving any medication in this regard. The subjects' screening contained a physical examination, a detailed history, electrocardiography, chest radiography, an exercise test, measuring of BSA and a comprehensive transthoracic echocardiography, including Doppler echocardiography, as described previously [8,15]. Subjects suffering from cardiopulmonary diseases such as coronary artery disease, systemic arterial hypertension, valvular or congenital heart disease, bicuspid aortic valve, congestive heart failure, cardiomyopathies and diabetes mellitus were rejected from the study.…”

Section: Methodsmentioning

confidence: 99%

“…Transthoracic 2D echocardiography is the most relevant non-invasive method to assess the right heart in clinical practice for diagnosis and follow-up in several diseases, such as cardiomyopathy and PH [8,9]. The echocardiographic assessment of the RV area is limited by technical difficulties and the complex geometry of the right ventricle [10,11,12].…”

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Reference Ranges for and Determinants of Right Ventricular Area in Healthy Adults by Two-Dimensional Echocardiography

et al. 2015

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Background: The right ventricular (RV) area is important for diagnosis and follow-up in patients with various diseases, such as in pulmonary hypertension. Objectives: The aim of this study was to define the reference ranges of the end-diastolic RV area in healthy adults and to assess the determining factors. Methods: In the first part of the study 860 healthy subjects (37.6% female; mean age 28 ± 5.84; 395 endurance athletes, 255 strength athletes and 210 non-athletes) were prospectively assessed. In the second part we performed a pooled analysis of studies published between 1979 and 2014 describing the RV area in healthy subjects (n = 5,248).Statistical analysis included the calculation of reference ranges and the analysis of determining factors. Results: Mean end-diastolic RV areas in 860 healthy subjects were significantly larger in endurance athletes (25.1 ± 2.0 cm²) compared with strength athletes (22.9 ± 1.7 cm²) and non-athletes (16.7 ± 2.0 cm², p < 0.001). In the synopsis of both data sets, mean end-diastolic RV area was significantly larger in European/American males (17 cm²) compared with females (14 cm², p < 0.001) and in Asian males (16 cm²) compared with females (13 cm², p < 0.001). The area increased with body surface area and older age. Conclusion: This is the largest data set to define RV size in healthy adults aged <50 years. RV area was determined by age, gender, body surface area, ethnicity and high-level exercise training. High standard deviations resulted in high values for the upper limit of the reference range, which might therefore not be useful as cut-off values for screening purposes. Gender- and ethnicity-specific reference ranges should be used. Further studies in subjects aged >50 years as well as in children are needed.

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“…Several decades of cross-sectional studies using multimodality noninvasive imaging techniques have established characteristic features of the athlete's heart including balanced biventricular dilation, 3,4 mild-to-moderate increases in left ventricular wall thickness, 5 and biatrial dilation. 6,7 More recently, carefully conducted longitudinal studies have established a cause and effect relationship between exercise training and cardiac remodeling. [8][9][10][11] The term exercise-induced cardiac remodeling (EICR), now in widespread use, encompasses the many structural and functional adaptations that occur in response to routine exercise training.…”

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confidence: 99%