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Left Ventricular Diastolic Function in Healthy Adult Individuals: Results of the World Alliance Societies of Echocardiography Normal Values Study.

by Miyoshi, Tatsuya; Desale, Sameer; Asch, Federico M.
Citation: Journal of the American Society of Echocardiography. 2020 Jul 30.Journal: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.Published: ; 2020ISSN: 0894-7317.Full author list: Miyoshi T; Addetia K; Citro R; Daimon M; Desale S; Fajardo PG; Kasliwal RR; Kirkpatrick JN; Monaghan MJ; Muraru D; Ogunyankin KO; Park SW; Ronderos RE; Sadeghpour A; Scalia GM; Takeuchi M; Tsang W; Tucay ES; Tude Rodrigues AC; Vivekanandan A; Zhang Y; Blitz A; Lang RM; Asch FM; WASE Investigators.UI/PMID: 32741597.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Health Research Institute | MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1016/j.echo.2020.06.008 (Click here) Abbreviated citation: J Am Soc Echocardiogr. 2020 Jul 30.Abstract: BACKGROUND: The World Alliance Societies of Echocardiography (WASE) study was conducted to describe echocardiographic normal values in adults and to compare races and nationalities using a uniform acquisition and measurement protocol. This report focuses on left ventricular (LV) diastolic function.Abstract: METHODS: WASE is an international, cross-sectional study. Participants were enrolled with equal distribution according to age and gender. Echocardiograms were analyzed in a core laboratory based on the latest American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines. Left ventricular diastolic function was assessed by E, E/A, e' velocities, E/e', left atrial volume index (LAVI), and tricuspid regurgitation velocity. Determination of LV diastolic function was made using the algorithm proposed by the guidelines.Abstract: RESULTS: A total of 2,008 subjects from 15 countries were enrolled. The majority were of white or Asian race (42.8%, 41.8%, respectively). E and E/e' were higher in female patients, while LAVI was similar in both genders. Consistent increase in E/e' and decrease in E/A, E, and e' were found as age increased. The upper limit of normal for LAVI was higher in WASE compared with the guidelines. The lower limits of normal for e' were smaller in elder groups than those in the guidelines, while the upper limits of normal for E/e' were below the guideline values. These findings suggest that the cutoff value for LAVI should be shifted upward and age-specific cutoff values for e' should be considered. In WASE, <93.6% of patients were classified as normal LV diastolic function using the guidelines' algorithm, and the proportion increased to 97.4% when applying the revised cutoff values for LAVI obtained in our study.Abstract: CONCLUSIONS: Guideline-recommended normal values for e' velocities and LAVI should be reconsidered. The algorithm for the determination of LV diastolic function proposed by the guidelines is useful, but adjustments to LAVI could further improve it. Copyright (c) 2020 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

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