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.

MedStar author(s):
Citation: Journal of the American Society of Echocardiography. 2021 May 24PMID: 34044105Institution: MedStar Health Research Institute | MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2021Local holdings: Available online through MWHC library: 2007 - presentISSN:
  • 0894-7317
Name of journal: Journal of the American Society of Echocardiography : official publication of the American Society of EchocardiographyAbstract: BACKGROUND: Assessment of cardiac output (CO) and stroke volume (SV) is essential to understand cardiac function and hemodynamics. These parameters can be examined by three echocardiographic techniques (pulsed wave Doppler, 2D and 3D). Whether these methods can be used interchangeably is unclear. The influence of age, sex, and ethnicity on CO and SV has also not been examined in-depth. In this report from the World Alliance of Societies of Echocardiography (WASE) Normal Values study, we aim to compare CO and SV in healthy adults according to age, sex, ethnicity and measurement techniques.CONCLUSION: Our results provide normal reference values for CO and SV, which differ by age, sex and race. Further, CI and SVI measurements by the different echocardiographic techniques are not interchangeable. All these factors need to be taken into account when evaluating cardiac function and hemodynamics in individual patients. Copyright (c) 2021. Published by Elsevier Inc.METHODS: 1450 adult subjects (53% males) free from heart, lung and kidney disease were prospectively enrolled in 15 countries with even distribution among age groups and sex. Subjects were divided into three age groups: young (18-40), middle (41-65) and old (>65 years), and three main racial groups: whites, blacks, and Asians. CO and SV were indexed (CI and SVI, respectively) to body surface area (BSA) and height and measured using three echocardiographic methods: Doppler, 2D, and 3D. Images were analyzed in two core laboratories (one for each 2D and 3D).RESULTS: CI and SVI were significantly lower by 2D compared to both Doppler and 3D methods in both sexes. SVI was significantly lower in females versus males by all 3 methods, while CI only differed by 2D. SVI decreased with aging by all three techniques, whereas CI declined only with 2D and 3D. CO and SV were smallest in Asians and largest in whites, and the differences persisted after normalization for BSA.All authors: Addetia K, Asch FM, Blankenhagen M, Citro R, Daimon M, Degel M, Gutierrez Fajardo P, Henry MP, Kasliwal RR, Kirkpatrick JN, Lang RM, Miyoshi T, Monaghan MJ, Mor-Avi V, Muraru D, Ogunyankin KO, Park SW, Patel HN, Ronderos RE, Rossmanith A, Sadeghpour A, Scalia GM, Schreckenberg M, Takeuchi M, Tsang W, Tucay ES, Tude Rodrigues AC, Vivekanandan A, WASE Investigators, Zhang YFiscal year: FY2021Digital Object Identifier: Date added to catalog: 2021-06-28
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Journal Article MedStar Authors Catalog Article 34044105 Available 34044105

Available online through MWHC library: 2007 - present

BACKGROUND: Assessment of cardiac output (CO) and stroke volume (SV) is essential to understand cardiac function and hemodynamics. These parameters can be examined by three echocardiographic techniques (pulsed wave Doppler, 2D and 3D). Whether these methods can be used interchangeably is unclear. The influence of age, sex, and ethnicity on CO and SV has also not been examined in-depth. In this report from the World Alliance of Societies of Echocardiography (WASE) Normal Values study, we aim to compare CO and SV in healthy adults according to age, sex, ethnicity and measurement techniques.

CONCLUSION: Our results provide normal reference values for CO and SV, which differ by age, sex and race. Further, CI and SVI measurements by the different echocardiographic techniques are not interchangeable. All these factors need to be taken into account when evaluating cardiac function and hemodynamics in individual patients. Copyright (c) 2021. Published by Elsevier Inc.

METHODS: 1450 adult subjects (53% males) free from heart, lung and kidney disease were prospectively enrolled in 15 countries with even distribution among age groups and sex. Subjects were divided into three age groups: young (18-40), middle (41-65) and old (>65 years), and three main racial groups: whites, blacks, and Asians. CO and SV were indexed (CI and SVI, respectively) to body surface area (BSA) and height and measured using three echocardiographic methods: Doppler, 2D, and 3D. Images were analyzed in two core laboratories (one for each 2D and 3D).

RESULTS: CI and SVI were significantly lower by 2D compared to both Doppler and 3D methods in both sexes. SVI was significantly lower in females versus males by all 3 methods, while CI only differed by 2D. SVI decreased with aging by all three techniques, whereas CI declined only with 2D and 3D. CO and SV were smallest in Asians and largest in whites, and the differences persisted after normalization for BSA.

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