Echocardiographic reference ranges for normal cardiac Doppler data: results from the NORRE Study


  • Morena Gonzalo
  • Popescu Bogdan A.
  • Penicka Martin
  • Ozyigit Tolga
  • Rodrigo Carbonero Jose David
  • Salustri Alessandro
  • van de Veire Nico
  • von Bardeleben Ralph Stephan
  • Vinereanu Dragos
  • Voigt Jens-Uwe
  • Zamorano Jose Luis
  • Bernard Anne
  • Donal Erwan
  • Lang Roberto M.
  • Badano Luigi P.
  • Lancellotti Patrizio
  • Caballero Luis
  • Kou Seisyou
  • Dulgheru Raluca
  • Gonjilashvili Natalia
  • Athanassopoulos George D.
  • Barone Daniele
  • Baroni Monica
  • Cardim Nuno
  • Diego Jose Juan
  • Oliva Maria Jose
  • Hagendorff Andreas
  • Hristova Krasimira
  • Lopez Teresa
  • Magne Julien
  • Martinez Christophe


  • Doppler echocardiography
  • NORRE Study
  • Reference values
  • Systolic and diastolic function


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' \textless8 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 \textless15 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

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