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Ethnic-Specific Normative Reference Values for Echocardiographic LA and LV Size, LV Mass, and Systolic Function: The EchoNoRMAL Study.
Pubmed ID: 25981507
Journal: JACC. Cardiovascular imaging
Publication Date: June 1, 2015
MeSH Terms: Humans, Male, Adult, Female, Aged, Aged, 80 and over, United States, Adolescent, Age Factors, Middle Aged, Sex Factors, Young Adult, Systole, Stroke Volume, Ventricular Function, Left, Echocardiography, Heart Ventricles, Reference Values, Heart Atria, Ethnicity
Grants: G9900264, MC_PC_11004
Authors: Gardin JM, Lip GY, Chirinos JA, Segers P, De Buyzere ML, Gillebert TC, Fuchs FD, de Simone G, de Simone G, Staessen JA, Doughty RN, Doughty RN, Hobbs FD, Hobbs FD, Hobbs FD, McMurray JJ, McMurray JJ, McMurray JJ, Nagueh SF, Poppe KK, Poppe KK, Poppe KK, Poppe KK, Poppe KK, Senior R, Senior R, Senior R, Senior R, Thomas L, Thomas L, Thomas L, Whalley GA, Whalley GA, Whalley GA, Whalley GA, Aune E, Aune E, Brown A, Brown A, Badano LP, Badano LP, Cameron V, Cameron V, Chadha DS, Chadha DS, Chahal N, Chahal N, Chien KL, Chien KL, Daimon M, Daimon M, Dalen H, Dalen H, Detrano R, Detrano R, Akif Duzenli M, Akif Duzenli M, Ezekowitz J, Di Pasquale P, Di Pasquale P, Fukuda S, Fukuda S, Gill PS, Gill PS, Grossman E, Grossman E, Kim HK, Kim HK, Kuznetsova T, Kuznetsova T, Leung NK, Leung NK, Linhart A, Linhart A, McDonagh TA, McDonagh TA, McGrady M, McGrady M, Mill JG, Mill JG, Mogelvang R, Mogelvang R, Muiesan ML, Muiesan ML, Ng AC, Ng AC, Ojji D, Ojji D, Otterstad JE, Otterstad JE, Petrovic DJ, Petrovic DJ, Prendergast B, Prendergast B, Rietzschel E, Rietzschel E, Schirmer H, Schirmer H, Schvartzman P, Schvartzman P, Simova I, Simova I, Sliwa K, Sliwa K, Stewart S, Stewart S, Stewart S, Squire IB, Squire IB, Takeuchi M, Takeuchi M, Perera R, Triggs CM, Au Yeung H, Beans Picón GA, Krum H, Altman DG, Richards AM, Troughton R, Su TC, Lin HJ, Davies J, Ford I, Ezekowitz JA, Anderson T, Dyck J, Van Daele CM, Walsh HA, Izzo R, De Luca N, Trimarco B, Goel K, Misra A, Chen PC, Skov Jensen J, Paterna S, Davies MK, Davies MK, Davis RC, Davis RC, Roalfe A, Calvert M, Freemantle N, Dargie HJ, Galasko G, Lahiri A, Carrington M, Zeitz C, Blauwet L, Moelmen Hansen HE, Støylen A, Thorstensen A, Watanabe H, Yoshikawa J, Chambers JC, Kooner J, Loke I, Ng L, Leung DY, Arnold L, Coffey S, d'Arcy J, Hammond C, Mabbett C, Lima C, Loudon M, Pinheiro N, Reynolds R, Muraru D, Peluso D, Dal Bianco L, Petrovic J, Katova T, Kaku K, Boyd A, Chia EM, Angelo LC, Pereira AC, Krieger JE, Rodrigues SL, Paini A, Agabiti Rosei E, Salvetti M
Cite As: Echocardiographic Normal Ranges Meta-Analysis of the Left Heart Collaboration. Ethnic-Specific Normative Reference Values for Echocardiographic LA and LV Size, LV Mass, and Systolic Function: The EchoNoRMAL Study. JACC Cardiovasc Imaging 2015 Jun;8(6):656-65. Epub 2015 May 14.
Studies:
Abstract
OBJECTIVES: This study sought to derive age-, sex-, and ethnic-appropriate adult reference values for left atrial (LA) and left ventricular (LV) dimensions and volumes, LV mass, fractional shortening, and ejection fraction (EF) derived from geographically diverse population studies. BACKGROUND: The current recommended reference values for measurements from echocardiography may not be suitable to the diverse world population to which they are now applied. METHODS: Population-based datasets of echocardiographic measurements from 22,404 adults without clinical cardiovascular or renal disease, hypertension, or diabetes were combined in an individual person data meta-analysis. Quantile regression was used to derive reference values at the 95th percentile (upper reference value [URV]) and fifth percentile (lower reference value [LRV]) of each measurement against age (treated as linear), separately within sex and ethnic groups. RESULTS: The URVs for left ventricular end-diastolic volume (LVEDV), LV end-systolic volume, and LV stroke volume (SV) were highest in Europeans and lowest in South Asians. Important sex and ethnic differences remained after indexation by body surface area or height for these measurements, as well as for the LRV for SV. LVEDV and SV decreased with increasing age for all groups. Importantly, the LRV for EF differed by ethnicity; there was a clear apparent difference between Europeans and Asians. The URVs for LV end-diastolic diameter and LV end-systolic diameter were higher for Europeans than those for East Asian, South Asian, and African people, particularly among men. Similarly, the URVs for LA diameter and volume were highest for Europeans. CONCLUSIONS: Sex- and/or ethnic-appropriate echocardiographic reference values are indicated for many measurements of LA and LV size, LV mass, and EF. Reference values for LV volumes and mass also differ across the age range.