3D echocardiographic reference ranges for normal left ventricular volumes and strain: results from the EACVI NORRE study

authors

• Bernard Anne
• Addetia Karima
• Dulgheru Raluca
• Caballero Luis
• Sugimoto Tadafumi
• Akhaladze Natela
• Athanassopoulos George D.
• Barone Daniele
• Baroni Monica
• Cardim Nuno
• Hagendorff Andreas
• Hristova Krasimira
• Ilardi Federica
• Lopez Teresa
• Morena Gonzalo de La
• Popescu Bogdan A.
• Penicka Martin
• Ozyigit Tolga
• David Rodrigo Carbonero Jose
• Veire Nico van De
• Stephan von Bardeleben Ralph
• Vinereanu Dragos
• Luis Zamorano Jose
• Martinez Christophe
• Magne Julien
• Cosyns Bernard
• Donal Erwan
• Habib Gilbert
• Badano Luigi P.
• Lang Roberto M.
• Lancellotti Patrizio

keywords

• Adult echocardiography
• Deformation imaging
• Left ventricular function
• Reference values
• Three-dimensional echocardiography

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.

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