Document Detail

Population-based reference values for 3D echocardiographic LV volumes and ejection fraction.
MedLine Citation:
PMID:  23236967     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The purpose of this study was to define age-, sex-, and ethnicity-specific reference values for 3-dimensional echocardiographic (3DE) left ventricular (LV) volumes and LV ejection fraction (LVEF) in a large cohort of European white and Indian Asian subjects.
BACKGROUND: Transthoracic 3DE imaging is recommended for the routine evaluation of LV volumes and function. However, there remains a lack of population-based reference values for 3DE LV volumes and LVEF, hindering adoption of this technique into routine clinical practice.
METHODS: We identified subjects from the LOLIPOP (London Life Sciences Prospective Population) study who were free of clinical cardiovascular disease, hypertension, and type 2 diabetes. All subjects underwent transthoracic 2-dimensional and 3D echocardiography for quantification of LV end-systolic volume index, LV end-diastolic volume index, and LVEF.
RESULTS: 3DE image quality was satisfactory in 978 subjects (89%) for the purposes of LV volumetric analysis. Indexed 3DE LV volumes were significantly smaller in female compared with male subjects and in Indian Asians compared with European whites. Upper limit of normal (mean ± 2 SD) reference values for the LV end-systolic volume index and LV end-diastolic volume index for the 4 ethnicity-sex subgroups were, respectively, as follows: European white men, 29 ml/m(2) and 67 ml/m(2); Indian Asian men, 26 ml/m(2) and 59 ml/m(2); European white women, 24 ml/m(2) and 58 ml/m(2); Indian Asian women, 23 ml/m(2) and 55 ml/m(2), respectively. Compared with 3DE studies, 2-dimensional echocardiography underestimated the LV end-systolic volume index and LV end-diastolic volume index by an average of 2.0 ml/m(2) and 4.7 ml/m(2), respectively. LVEF was similar between in all 4 groups and between 2- and 3-dimensional techniques, with a lower cutoff of 52% for the whole cohort.
CONCLUSIONS: These reference values are based on the largest 3DE study performed to date that should facilitate the standardization of the technique and encourage its adoption for the routine assessment of LV volumes and LVEF in the clinical echocardiography laboratory. This study supports the application of ethnicity-specific reference values for indexed LV volumes.
Navtej S Chahal; Tiong K Lim; Piyush Jain; John C Chambers; Jaspal S Kooner; Roxy Senior
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  5     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-14     Completed Date:  2013-05-21     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1191-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Department of Cardiovascular Medicine, Northwick Park Hospital, Harrow, United Kingdom.
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MeSH Terms
Cardiac Volume / physiology*
Echocardiography, Three-Dimensional / methods*
Heart Ventricles / ultrasonography*
Middle Aged
Prospective Studies
Reference Values
Reproducibility of Results
Stroke Volume / physiology*
Ventricular Function, Left / physiology*
Grant Support
SP/04/002//British Heart Foundation
Comment In:
JACC Cardiovasc Imaging. 2012 Dec;5(12):1198-200   [PMID:  23236968 ]
JACC Cardiovasc Imaging. 2013 Apr;6(4):530   [PMID:  23579018 ]
JACC Cardiovasc Imaging. 2013 Apr;6(4):530-1   [PMID:  23579017 ]

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