Luis Caballero1, Seisyou Kou2, Raluca Dulgheru3, Natalia Gonjilashvili4, George D Athanassopoulos5, Daniele Barone6, Monica Baroni7, Nuno Cardim8, Jose Juan Gomez de Diego9, Maria Jose Oliva1, Andreas Hagendorff10, Krasimira Hristova11, Teresa Lopez12, Julien Magne13, Christophe Martinez3, Gonzalo de la Morena1, Bogdan A Popescu14, Martin Penicka15, Tolga Ozyigit16, Jose David Rodrigo Carbonero17, Alessandro Salustri18, Nico Van De Veire19, Ralph Stephan Von Bardeleben20, Dragos Vinereanu21, Jens-Uwe Voigt22, Jose Luis Zamorano23, Anne Bernard24, Erwan Donal25, Roberto M Lang26, Luigi P Badano27, Patrizio Lancellotti28. 1. Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain. 2. Department of Cardiology, St. Marianna University, School of Medicine, Kawasaki, Japan. 3. University of Liège Hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liège, Belgium. 4. Echocardiography Laboratory of Adult Cardiology Department of the JO ANN Medical Center, Tbilisi, Georgia. 5. Noninvasive Diagnostics Department-Onassis Cardiac Surgery Center, Athens, Greece. 6. Laboratory of Cardiovascular Ecography-Cardiology Dpt-S. Andrea Hospital, La Spezia, Italy. 7. Laboratorio Di Ecocardiografia Adulti, Fondazione Toscana 'G.Monasterio'-Ospedale Del Cuore, Massa, Italy. 8. Echocardiography Laboratory, Hospital da Luz, Lisbon, Portugal. 9. Unidad de Imagen - Cardiovascular. ICV. Hospital Clinico San Carlos, Madrid, Spain. 10. Echokardiographie-Labore des Universitätsklinikums AöR, Department of Cardiology-Angiology, University of Leipzig, Leipzig, Germany. 11. Department of Noninvasive Functional Diagnostic and Imaging, University National Heart Hospital, Sofia, Bulgaria. 12. Cardiology Department, La Paz Hospital, Madrid, Spain. 13. CHU Limoges, Hôpital Dupuytren, Pôle Coeur-Poumon-Rein, Service Cardiologie, Limoges, France. 14. 'Carol Davila' University of Medicine and Pharmacy-Euroecolab, Institute of Cardiovascular Diseases, Bucharest, Romania. 15. Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium. 16. VKV Amerikan Hastanesi, Kardiyoloji Bölümü, Istanbul, Turkey. 17. Laboratorio de Ecocardiografia Hospital de Cruces-Barakaldo, Barakaldo, Spain. 18. SheikhKhalifa Medical City, Abu Dhabi, UAE. 19. Echocardiography Unit, AZ Maria Middelares Gent, Gent, Belgium. 20. Medical Department Cardiology, Universitätsmedizin of the Johannes Gutenberg-University Mainz, Mainz, Germany. 21. Cardiovascular Research Unit, University and Emergency Hospital, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania. 22. Echocardiography Laboratory, Department of Cardiovascular Diseases, University Hospital Gasthuisberg, Leuven, Belgium. 23. University Hospital Ramón y Cajal, Madrid. Spain. 24. CHU Tours, France et Université de Tours, Tours, France. 25. CIC-IT U 804, CHU Rennes, Université Rennes 1, Service de Cardiologie, CHU RENNES, Rennes, France. 26. Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA. 27. Department of Cardiac, Thoracic and Vascular Sciences University of Padova, School of Medicine, Padova, Italy. 28. University of Liège Hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liège, Belgium GVM Care and Research, E.S. Health Science Foundation, Lugo, Ravenna, Italy plancellotti@chu.ulg.ac.be.
Abstract
AIMS: Reference values for Doppler parameters according to age and gender are recommended for the assessment of heart physiology, specifically for left ventricular (LV) diastolic function. In this study, we report normal reference ranges for Doppler parameters obtained in a large group of healthy volunteers. Echocardiographic data were acquired using state-of-the-art cardiac ultrasound equipment following Doppler acquisition and measurement protocols approved by the European Association of Cardiovascular Imaging. METHODS AND RESULTS: A total of 449 (mean age: 45.8 ± 13.7 years) healthy volunteers (198 men and 251 women) were enrolled at the collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. A comprehensive echocardiographic examination was obtained from all subjects following predefined protocols. The majority of the Doppler diastolic parameters (e', E/e') as well as right ventricle systolic s' wave velocity were similar in men and women. Left ventricle s' wave velocity was higher in men than in women. E wave and e' were higher in younger subjects and decreased progressively in the older ones. E/e' ratio increased with ageing. Septal e' <8 cm/s was present in 19.7% of the subjects in the 40-60 year group and in 55% of those in the ≥60 year group. However, the cut-off value of average E/e' or lateral E/e' remained <15 or 13, respectively, in the majority of patients. CONCLUSION: The NORRE study provides the reference values for the most useful Doppler parameters in the evaluation of heart physiology. These data highlight the need of using age-specific reference values especially for the diagnosis of LV systolic and diastolic dysfunction and for the estimation of LV filling pressures. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Reference values for Doppler parameters according to age and gender are recommended for the assessment of heart physiology, specifically for left ventricular (LV) diastolic function. In this study, we report normal reference ranges for Doppler parameters obtained in a large group of healthy volunteers. Echocardiographic data were acquired using state-of-the-art cardiac ultrasound equipment following Doppler acquisition and measurement protocols approved by the European Association of Cardiovascular Imaging. METHODS AND RESULTS: A total of 449 (mean age: 45.8 ± 13.7 years) healthy volunteers (198 men and 251 women) were enrolled at the collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. A comprehensive echocardiographic examination was obtained from all subjects following predefined protocols. The majority of the Doppler diastolic parameters (e', E/e') as well as right ventricle systolic s' wave velocity were similar in men and women. Left ventricle s' wave velocity was higher in men than in women. E wave and e' were higher in younger subjects and decreased progressively in the older ones. E/e' ratio increased with ageing. Septal e' <8 cm/s was present in 19.7% of the subjects in the 40-60 year group and in 55% of those in the ≥60 year group. However, the cut-off value of average E/e' or lateral E/e' remained <15 or 13, respectively, in the majority of patients. CONCLUSION: The NORRE study provides the reference values for the most useful Doppler parameters in the evaluation of heart physiology. These data highlight the need of using age-specific reference values especially for the diagnosis of LV systolic and diastolic dysfunction and for the estimation of LV filling pressures. Published on behalf of the European Society of Cardiology. All rights reserved.
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