Echocardiographic reference ranges for normal non-invasive myocardial work indices results from the EACVI NORRE study


  • Manganaro Roberta
  • Marchetta Stella
  • Dulgheru Raluca
  • Ilardi Federica
  • Sugimoto Tadafumi
  • Robinet Sébastien
  • Cimino Sara
  • Go Yun Yun
  • Bernard Anne
  • Kacharava George
  • Athanassopoulos George D
  • Barone Daniele
  • Baroni Monica
  • Cardim Nuno
  • Hagendorff Andreas
  • Hristova Krasimira
  • López-Fernández Teresa
  • de la Morena Gonzalo
  • Popescu Bogdan A
  • Penicka Martin
  • Ozyigit Tolga
  • Rodrigo Carbonero Jose David
  • van de Veire Nico
  • von Bardeleben Ralph Stephan
  • Vinereanu Dragos
  • Zamorano Jose Luis
  • Rosca Monica
  • Calin Andreea
  • Moonen Marie
  • Magne Julien
  • Cosyns Bernard
  • Galli Elena
  • Donal Erwan
  • Carerj Scipione
  • Zito Concetta
  • Santoro Ciro
  • Galderisi Maurizio
  • Badano Luigi P
  • Lang Roberto M
  • Oury Cecile
  • Lancellotti Patrizio


  • 2D echocardiography
  • Adult echocardiography
  • Myocardial work
  • Reference values


Aims - To obtain the normal ranges for 2D echocardiographic (2DE) indices of myocardial work (MW) from a large group of healthy volunteers over a wide range of ages and gender. Methods and results - A total of 226 (85 men, mean age: 45 ± 13 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. Global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE) were estimated from left ventricle (LV) pressure-strain loops. Peak LV systolic pressure was non-invasively derived from brachial artery cuff pressure. The lowest values of MW indices in men and women were 1270 mmHg% and 1310 mmHg% for GWI, 1650 mmHg% and 1544 mmHg% for GCW, and 90% and 91% for GWE, respectively. The highest value for GWW was 238 mmHg% in men and 239 mmHg% in women. Men had significant lower values of GWE and higher values of GWW. GWI and GCW significantly increased with age in women. Conclusion - The NORRE study provides useful 2DE reference ranges for novel indices of non-invasive MW.

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