Normal Values of Left Ventricular Size and Function on Three-Dimensional Echocardiography: Results of the World Alliance Societies of Echocardiography Study.

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Citation: Journal of the American Society of Echocardiography. 2021 Dec 14PMID: 34920112Institution: 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 - presentName of journal: Journal of the American Society of Echocardiography : official publication of the American Society of EchocardiographyAbstract: BACKGROUND: Echocardiography remains the most widely used modality to assess left ventricular (LV) chamber size and function. Currently this assessment is most frequently performed using two-dimensional (2D) echocardiography. However, three-dimensional (3D) echocardiography has been shown to be more accurate and reproducible than 2D echocardiography. Current normative reference values for 3D LV analysis are based predominantly on data from North America and Europe. The World Alliance Societies of Echocardiography study was designed to sample normal subjects from around the world to provide more universal global reference ranges. The aim of this study was to assess the worldwide feasibility of LV 3D echocardiography and report on size and functional measurements.CONCLUSIONS: Age, sex, and race should be considered when defining normal reference values for LV dimension and functional parameters obtained by 3D echocardiography. Copyright (c) 2021 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.METHODS: A total of 2,262 healthy subjects were prospectively enrolled from 19 centers in 15 countries. Three-dimensional LV full-volume data sets were obtained and analyzed offline using vendor-neutral software. Measurements included LV end-diastolic and end-systolic volumes, LV ejection fraction (LVEF), global longitudinal strain (GLS), and global circumferential strain. Results were categorized by age (18-40, 41-65, and >65 years), sex, and race.RESULTS: A total of 1,589 subjects (feasibility 70%) had adequate LV data sets for analysis. Mean normal values for indexed end-diastolic volume, end-systolic volume, and LVEF in men and women were 70 +/- 15 and 65 +/- 12 mL/m2, 28 +/- 7 and 25 +/- 6 mL/m2, and 60 +/- 5% and 62 +/- 5%, respectively. Men had larger LV volumes and lower LVEFs than women. GLS and global circumferential strain were higher in magnitude in women. In both sexes, LV volumes were lower and LVEF tended to be higher with increasing age, especially considering the differences between the youngest and oldest age groups. Although GLS was similar across age groups in men, in women, the youngest and middle-age cohorts revealed higher magnitudes of GLS compared with the oldest age group. Global circumferential strain was higher in magnitude at older age in both men and women. Finally, Asians had smaller chamber sizes and higher LVEFs and absolute strain values than both blacks and whites.All authors: Addetia K, Amuthan V, Asch FM, Blankenhagen M, Citro R, Daimon M, Degel M, Gutierrez Fajardo P, Hitschrich N, Kasliwal RR, Kirkpatrick JN, Lang RM, Miyoshi T, Monaghan MJ, Mor-Avi V, Muraru D, Ogunyankin KO, Park SW, Ronderos RE, Sadeghpour A, Scalia GM, Schreckenberg M, Takeuchi M, Tsang W, Tucay ES, Tude Rodrigues AC, WASE Investigators, Zhang YFiscal year: FY2022Digital Object Identifier: Date added to catalog: 2022-02-21
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Journal Article MedStar Authors Catalog Article 34920112 Available 34920112

Available online through MWHC library: 2007 - present

BACKGROUND: Echocardiography remains the most widely used modality to assess left ventricular (LV) chamber size and function. Currently this assessment is most frequently performed using two-dimensional (2D) echocardiography. However, three-dimensional (3D) echocardiography has been shown to be more accurate and reproducible than 2D echocardiography. Current normative reference values for 3D LV analysis are based predominantly on data from North America and Europe. The World Alliance Societies of Echocardiography study was designed to sample normal subjects from around the world to provide more universal global reference ranges. The aim of this study was to assess the worldwide feasibility of LV 3D echocardiography and report on size and functional measurements.

CONCLUSIONS: Age, sex, and race should be considered when defining normal reference values for LV dimension and functional parameters obtained by 3D echocardiography. Copyright (c) 2021 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

METHODS: A total of 2,262 healthy subjects were prospectively enrolled from 19 centers in 15 countries. Three-dimensional LV full-volume data sets were obtained and analyzed offline using vendor-neutral software. Measurements included LV end-diastolic and end-systolic volumes, LV ejection fraction (LVEF), global longitudinal strain (GLS), and global circumferential strain. Results were categorized by age (18-40, 41-65, and >65 years), sex, and race.

RESULTS: A total of 1,589 subjects (feasibility 70%) had adequate LV data sets for analysis. Mean normal values for indexed end-diastolic volume, end-systolic volume, and LVEF in men and women were 70 +/- 15 and 65 +/- 12 mL/m2, 28 +/- 7 and 25 +/- 6 mL/m2, and 60 +/- 5% and 62 +/- 5%, respectively. Men had larger LV volumes and lower LVEFs than women. GLS and global circumferential strain were higher in magnitude in women. In both sexes, LV volumes were lower and LVEF tended to be higher with increasing age, especially considering the differences between the youngest and oldest age groups. Although GLS was similar across age groups in men, in women, the youngest and middle-age cohorts revealed higher magnitudes of GLS compared with the oldest age group. Global circumferential strain was higher in magnitude at older age in both men and women. Finally, Asians had smaller chamber sizes and higher LVEFs and absolute strain values than both blacks and whites.

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