Anne Bernard1,2, Karima Addetia3, Raluca Dulgheru1, Luis Caballero4, Tadafumi Sugimoto1, Natela Akhaladze5, George D Athanassopoulos6, Daniele Barone7, Monica Baroni8, Nuno Cardim9, Andreas Hagendorff10, Krasimira Hristova11, Federica Ilardi1, Teresa Lopez12, Gonzalo de la Morena4, Bogdan A Popescu13, Martin Penicka14, Tolga Ozyigit15, Jose David Rodrigo Carbonero16, Nico van de Veire17, Ralph Stephan Von Bardeleben18, Dragos Vinereanu19, Jose Luis Zamorano20, Christophe Martinez1, Julien Magne21, Bernard Cosyns22, Erwan Donal23, Gilbert Habib24,25, Luigi P Badano26, Roberto M Lang3, Patrizio Lancellotti1,27. 1. Departments of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium. 2. Cardiology Department, CHU Tours, France et Université de Tours, Tours, France. 3. Department of Medicine, University of Chicago Medical Center, IL, USA. 4. Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Clinico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain. 5. Echocardiography Laboratory of Adult Cardiology Department of the JO ANN Medical Center, Tbilisi, GA. 6. Noninvasive Diagnostics Department - Onassis Cardiac Surgery Center, Athens, Greece. 7. Laboratory of Cardiovascular Ecography, Cardiology Department, S. Andrea Hospital, La Spezia, Italy. 8. Laboratorio Ecocardiografia Adulti, Fondazione Toscana "G.Monasterio"- Ospedale Del Cuore, Massa, Italy. 9. Hospital da Luz, Echocardiography Laboratory, Lisbon, Portugal. 10. Department of Cardiology-Angiology, Echokardiographie-Labore des Universitätsklinikums AöR, 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. "Carol Davila" University of Medicine and Pharmacy - Euroecolab, Institute of Cardiovascular Diseases, Bucharest, Romania. 14. Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium. 15. VKV Amerikan Hastanesi, Kardiyoloji Bölümü, Istanbul, Turkey. 16. Laboratorio de Ecocardiografia Hospital de Cruces, Barakaldo, Spain. 17. Echocardiography Unit, AZ Maria Middelares, Gent, Belgium. 18. Medical Department Cardiology, Universitätsmedizin of the Johannes Gutenberg, University Mainz, Mainz, Germany. 19. Cardiovascular Research Unit, University and Emergency Hospital, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania. 20. University Alcala, Hospital Ramón y Cajal, Madrid, Spain. 21. CHU Dupuytren, Limoges, France. 22. CHVZ (Centrum voor Hart en Vaatziekten), Universitair ziekenhuis Brussel; and ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Brussels, Belgium. 23. CIC-IT U 1414, CHU Rennes, Université Rennes 1, Service de Cardiologie, CHU RENNES, France. 24. Aix-Marseille Université, 13005 Marseille France. 25. Cardiology Department, APHM, La Timone Hospital, Marseille, France. 26. Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, School of Medicine, Padova, Italy. 27. Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy.
Abstract
AIM: To obtain the normal ranges for 3D echocardiography (3DE) measurement of left ventricular (LV) volumes, function, and strain from a large group of healthy volunteers. METHODS AND RESULTS: A total of 440 (mean age: 45 ± 13 years) out of the 734 healthy subjects enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study had good-quality 3DE data sets that have been analysed with a vendor-independent software package allowing homogeneous measurements regardless of the echocardiographic machine used to acquire the data sets. Upper limits of LV end-diastolic and end-systolic volumes were larger in men (97 and 42 mL/m2) than in women (82 and 35 mL/m2; P < 0.0001). Conversely, lower limits of LV ejection fraction were higher in women than in men (51% vs. 50%; P < 0.01). Similarly, all strain components were higher in women than in men. Lower range was -18.6% in men and -19.5% in women for 3D longitudinal strain, -27.0% and -27.6% for 3D circumferential strain, -33.2% and -34.4% for 3D tangential strain and 38.8% and 40.7% for 3D radial strain, respectively. LV volumes decreased with age in both genders (P < 0.0001), whereas LV ejection fraction increased with age only in men. Among 3DE LV strain components, the only one, which did not change with age was longitudinal strain. CONCLUSION: The NORRE study provides applicable 3D echocardiographic reference ranges for LV function assessment. Our data highlight the importance of age- and gender-specific reference values for both LV volumes and strain. Published on behalf of the European Society of Cardiology. All rights reserved.
AIM: To obtain the normal ranges for 3D echocardiography (3DE) measurement of left ventricular (LV) volumes, function, and strain from a large group of healthy volunteers. METHODS AND RESULTS: A total of 440 (mean age: 45 ± 13 years) out of the 734 healthy subjects enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study had good-quality 3DE data sets that have been analysed with a vendor-independent software package allowing homogeneous measurements regardless of the echocardiographic machine used to acquire the data sets. Upper limits of LV end-diastolic and end-systolic volumes were larger in men (97 and 42 mL/m2) than in women (82 and 35 mL/m2; P < 0.0001). Conversely, lower limits of LV ejection fraction were higher in women than in men (51% vs. 50%; P < 0.01). Similarly, all strain components were higher in women than in men. Lower range was -18.6% in men and -19.5% in women for 3D longitudinal strain, -27.0% and -27.6% for 3D circumferential strain, -33.2% and -34.4% for 3D tangential strain and 38.8% and 40.7% for 3D radial strain, respectively. LV volumes decreased with age in both genders (P < 0.0001), whereas LV ejection fraction increased with age only in men. Among 3DE LV strain components, the only one, which did not change with age was longitudinal strain. CONCLUSION: The NORRE study provides applicable 3D echocardiographic reference ranges for LV function assessment. Our data highlight the importance of age- and gender-specific reference values for both LV volumes and strain. Published on behalf of the European Society of Cardiology. All rights reserved.
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