Normal reference values of echocardiographic measurements in young Egyptian adults

Normal values for echocardiographic measurements are widely based on cohorts from North American populations. Differences have been shown to exist that could be attributed to racial and ethnic differences. To define the normal echocardiographic reference values for various cardiac measurements in yo...

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Published inThe Egyptian heart journal Vol. 68; no. 4; pp. 209 - 215
Main Authors El Missiri, Ahmed Mohamed, El Meniawy, Khaled Abdel Lateef, Sakr, Sherif Abdel Salam, Mohamed, Ayat Shams El-deen
Format Journal Article
LanguageEnglish
Published Elsevier B.V 01.12.2016
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ISSN1110-2608
2090-911X
DOI10.1016/j.ehj.2016.01.002

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Abstract Normal values for echocardiographic measurements are widely based on cohorts from North American populations. Differences have been shown to exist that could be attributed to racial and ethnic differences. To define the normal echocardiographic reference values for various cardiac measurements in young, healthy Egyptian adults. This study was performed on 1,364 healthy adults aged 18–35years. Standard trans-thoracic echocardiographic studies were performed to obtain end diastole measurements of left ventricular (LV) posterior wall thickness (PWd), interventricular septum thickness (IVSd), LV internal dimensions at end diastole (LVEDD) and end systole (LVESD), left atrial (LA) diameter, aortic root diameter and right ventricular outflow dimension (RVd). LV ejection fraction (LVEF), LV mass and relative wall thickness were assessed. All measurements were then indexed to body surface area (BSA). Based on our results we proposed normal reference values for young Egyptian adults. On comparing subjects according to gender, absolute measurements showed males had significantly larger LVEDD, LVESD, IVSd, PWd, LV mass, LA anteroposterior diameter and aortic root diameter (p<0.0001 for each). LV ejection fraction was higher in females (p=0.008). There was no difference regarding RVd (p=0.118). Females had larger indexed LVEDD (p=0.0003), indexed LA and aortic root diameters (p=0.0005 and 0.007 respectively) and indexed RVd (p<0.0001). However, indexed LV mass was larger in males 83.56±20.37 versus 77.76±18.56g/m2 (p<0.0001). We proposed normal values for absolute and indexed echocardiographic measurements based on our results. Estimation of local reference values is important to define normalcy. The main difference from international values was a higher upper reference limit for LV mass especially in females and relatively smaller LA dimensions in young Egyptians.
AbstractList Normal values for echocardiographic measurements are widely based on cohorts from North American populations. Differences have been shown to exist that could be attributed to racial and ethnic differences. To define the normal echocardiographic reference values for various cardiac measurements in young, healthy Egyptian adults. This study was performed on 1,364 healthy adults aged 18–35years. Standard trans-thoracic echocardiographic studies were performed to obtain end diastole measurements of left ventricular (LV) posterior wall thickness (PWd), interventricular septum thickness (IVSd), LV internal dimensions at end diastole (LVEDD) and end systole (LVESD), left atrial (LA) diameter, aortic root diameter and right ventricular outflow dimension (RVd). LV ejection fraction (LVEF), LV mass and relative wall thickness were assessed. All measurements were then indexed to body surface area (BSA). Based on our results we proposed normal reference values for young Egyptian adults. On comparing subjects according to gender, absolute measurements showed males had significantly larger LVEDD, LVESD, IVSd, PWd, LV mass, LA anteroposterior diameter and aortic root diameter (p<0.0001 for each). LV ejection fraction was higher in females (p=0.008). There was no difference regarding RVd (p=0.118). Females had larger indexed LVEDD (p=0.0003), indexed LA and aortic root diameters (p=0.0005 and 0.007 respectively) and indexed RVd (p<0.0001). However, indexed LV mass was larger in males 83.56±20.37 versus 77.76±18.56g/m2 (p<0.0001). We proposed normal values for absolute and indexed echocardiographic measurements based on our results. Estimation of local reference values is important to define normalcy. The main difference from international values was a higher upper reference limit for LV mass especially in females and relatively smaller LA dimensions in young Egyptians.
Author El Meniawy, Khaled Abdel Lateef
El Missiri, Ahmed Mohamed
Mohamed, Ayat Shams El-deen
Sakr, Sherif Abdel Salam
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Cites_doi 10.1016/S0002-8703(00)90084-X
10.1056/NEJM197412052912304
10.1016/j.ahj.2009.12.015
10.1161/01.HYP.9.2_Pt_2.II36
10.1161/HYPERTENSIONAHA.110.150250
10.1136/hrt.2009.173153
10.1093/ehjci/jet265
10.1093/ehjci/jet008
10.1016/0002-9149(86)90771-X
10.1007/s00246-014-0932-4
10.1016/j.echo.2010.05.010
10.1016/j.echo.2014.10.003
10.1016/j.amjhyper.2004.08.032
10.1056/NEJM198710223171717
10.1161/CIRCIMAGING.113.000690
10.1067/mje.2001.113258
10.1253/circj.CJ-08-0171
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References Chirinos, Segers, De Buyzere, Kronmal, Raja, De Bacquer (b0090) 2010; 56
Lancellotti (b0020) 2014; 15
Chahal, Lim, Jain, Chambers, Kooner, Senior (b0085) 2010; 96
de Simone, Kizer, Chinali, Roman, Bella, Best (b0095) 2005; 18
Lang, Badano, Mor-Avi, Afilalo, Armstrong, Ernande (b0025) 2015; 28
Lancellotti, Badano, Lang, Akhaladze, Athanassopoulos, Barone (b0010) 2013; 14
Daimon, Watanabe, Abe, Hirata, Hozumi, Ishii (b0030) 2008; 72
Motz, Schumacher, Nürnberg, Viemann, Grafmüller, Fiedler (b0065) 2014; 35
Teichholz, Cohen, Sonnenblick, Gorlin (b0050) 1974; 291
Vasan, Levy, Larson, Benjamin (b0075) 2000; 139
Okrah, Vaughan-Sarrazin, Cram (b0015) 2010; 159
Pfaffenberger, Bartko, Graf, Pernicka, Babayev, Lolic (b0080) 2013; 6
Ilercil, O’Grady, Roman, Paranicas, Lee, Welty (b0035) 2001; 14
Devereux, Alonso, Lutas, Gottlieb, Campo, Sachs (b0055) 1986; 57
Mosteller (b0040) 1987; 317
Gardin, Savage, Ware, Henry (b0070) 1987; 9
Vasan, Levy, Larson, Benjamin (b0005) 2000; 139
Marshal, Bangert (b0060) 2008
Rudski, Lai, Afilalo, Hua, Handschumacher, Chandrasekaran (b0045) 2010; 23
Lancellotti (10.1016/j.ehj.2016.01.002_b0020) 2014; 15
Lancellotti (10.1016/j.ehj.2016.01.002_b0010) 2013; 14
Gardin (10.1016/j.ehj.2016.01.002_b0070) 1987; 9
Rudski (10.1016/j.ehj.2016.01.002_b0045) 2010; 23
Teichholz (10.1016/j.ehj.2016.01.002_b0050) 1974; 291
Daimon (10.1016/j.ehj.2016.01.002_b0030) 2008; 72
Devereux (10.1016/j.ehj.2016.01.002_b0055) 1986; 57
Motz (10.1016/j.ehj.2016.01.002_b0065) 2014; 35
Mosteller (10.1016/j.ehj.2016.01.002_b0040) 1987; 317
Marshal (10.1016/j.ehj.2016.01.002_b0060) 2008
de Simone (10.1016/j.ehj.2016.01.002_b0095) 2005; 18
Okrah (10.1016/j.ehj.2016.01.002_b0015) 2010; 159
Ilercil (10.1016/j.ehj.2016.01.002_b0035) 2001; 14
Lang (10.1016/j.ehj.2016.01.002_b0025) 2015; 28
Pfaffenberger (10.1016/j.ehj.2016.01.002_b0080) 2013; 6
Vasan (10.1016/j.ehj.2016.01.002_b0075) 2000; 139
Chirinos (10.1016/j.ehj.2016.01.002_b0090) 2010; 56
Vasan (10.1016/j.ehj.2016.01.002_b0005) 2000; 139
Chahal (10.1016/j.ehj.2016.01.002_b0085) 2010; 96
References_xml – volume: 56
  start-page: 91
  year: 2010
  end-page: 98
  ident: b0090
  article-title: Left ventricular mass: allometric scaling, normative values, effect of obesity, and prognostic performance
  publication-title: Hypertension
– volume: 9
  start-page: II36
  year: 1987
  end-page: II39
  ident: b0070
  article-title: Effect of age, sex, and body surface area on echocardiographic left ventricular wall mass in normal subjects
  publication-title: Hypertension
– volume: 139
  start-page: 412
  year: 2000
  end-page: 422
  ident: b0075
  article-title: Interpretation of echocardiographic measurements: a call for standardization
  publication-title: Am Heart J
– volume: 14
  start-page: 601
  year: 2001
  end-page: 611
  ident: b0035
  article-title: Reference values for echocardiographic measurements in urban and rural populations of differing ethnicity: the strong heart study
  publication-title: J Am Soc Echocardiogr
– volume: 291
  start-page: 1220
  year: 1974
  end-page: 1226
  ident: b0050
  article-title: Study of left ventricular geometry and function by B-scan ultrasonography in patients with and without asynergy
  publication-title: N Engl J Med.
– volume: 23
  start-page: 685
  year: 2010
  end-page: 713
  ident: b0045
  article-title: Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography
  publication-title: J Am Soc Echocardiogr
– volume: 6
  start-page: 1073
  year: 2013
  end-page: 1079
  ident: b0080
  article-title: Size matters! Impact of age, sex, height, and weight on the normal heart size
  publication-title: Circ Cardiovasc Imaging
– volume: 317
  start-page: 1098
  year: 1987
  ident: b0040
  article-title: Simplified calculation of body surface area
  publication-title: N Engl J Med
– volume: 15
  start-page: 253
  year: 2014
  end-page: 254
  ident: b0020
  article-title: Normal reference ranges for echocardiography: do we really need more?
  publication-title: Eur Heart J Cardiovasc Imaging
– volume: 57
  start-page: 450
  year: 1986
  end-page: 458
  ident: b0055
  article-title: Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings
  publication-title: Am J Cardiol
– volume: 96
  start-page: 466
  year: 2010
  end-page: 471
  ident: b0085
  article-title: Ethnicity-related differences in left ventricular function, structure and geometry: a population study of UK Indian Asian and European white subjects
  publication-title: Heart
– start-page: 19
  year: 2008
  ident: b0060
  article-title: Clinical biochemistry: metabolic and clinical aspects
– volume: 14
  start-page: 303
  year: 2013
  end-page: 308
  ident: b0010
  article-title: Normal reference ranges for echocardiography: rationale, study design, and methodology (NORRE study)
  publication-title: Eur Heart J Cardiovasc Imaging
– volume: 72
  start-page: 1859
  year: 2008
  end-page: 1866
  ident: b0030
  article-title: Normal values of echocardiographic parameters in relation to age in a healthy Japanese population: the JAMP study
  publication-title: Circ J
– volume: 28
  start-page: 1
  year: 2015
  end-page: 39
  ident: b0025
  article-title: Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging
  publication-title: J Am Soc Echocardiogr
– volume: 35
  start-page: 1327
  year: 2014
  end-page: 1336
  ident: b0065
  article-title: Echocardiographic measurements of cardiac dimensions correlate better with body length than with body weight or body surface area
  publication-title: Pediatr Cardiol
– volume: 139
  start-page: 412
  year: 2000
  end-page: 422
  ident: b0005
  article-title: Interpretation of echocardiographic measurements: a call for standardization
  publication-title: Am Heart J
– volume: 18
  start-page: 191
  year: 2005
  end-page: 196
  ident: b0095
  article-title: Normalization for body size and population-attributable risk of left ventricular hypertrophy: the strong heart study
  publication-title: Am J Hypertens
– volume: 159
  start-page: 477
  year: 2010
  end-page: 483
  ident: b0015
  article-title: Trends in echocardiography utilization in the veterans administration healthcare system
  publication-title: Am Heart J
– start-page: 19
  year: 2008
  ident: 10.1016/j.ehj.2016.01.002_b0060
– volume: 139
  start-page: 412
  year: 2000
  ident: 10.1016/j.ehj.2016.01.002_b0005
  article-title: Interpretation of echocardiographic measurements: a call for standardization
  publication-title: Am Heart J
  doi: 10.1016/S0002-8703(00)90084-X
– volume: 291
  start-page: 1220
  year: 1974
  ident: 10.1016/j.ehj.2016.01.002_b0050
  article-title: Study of left ventricular geometry and function by B-scan ultrasonography in patients with and without asynergy
  publication-title: N Engl J Med.
  doi: 10.1056/NEJM197412052912304
– volume: 159
  start-page: 477
  year: 2010
  ident: 10.1016/j.ehj.2016.01.002_b0015
  article-title: Trends in echocardiography utilization in the veterans administration healthcare system
  publication-title: Am Heart J
  doi: 10.1016/j.ahj.2009.12.015
– volume: 9
  start-page: II36
  year: 1987
  ident: 10.1016/j.ehj.2016.01.002_b0070
  article-title: Effect of age, sex, and body surface area on echocardiographic left ventricular wall mass in normal subjects
  publication-title: Hypertension
  doi: 10.1161/01.HYP.9.2_Pt_2.II36
– volume: 56
  start-page: 91
  year: 2010
  ident: 10.1016/j.ehj.2016.01.002_b0090
  article-title: Left ventricular mass: allometric scaling, normative values, effect of obesity, and prognostic performance
  publication-title: Hypertension
  doi: 10.1161/HYPERTENSIONAHA.110.150250
– volume: 96
  start-page: 466
  year: 2010
  ident: 10.1016/j.ehj.2016.01.002_b0085
  article-title: Ethnicity-related differences in left ventricular function, structure and geometry: a population study of UK Indian Asian and European white subjects
  publication-title: Heart
  doi: 10.1136/hrt.2009.173153
– volume: 139
  start-page: 412
  year: 2000
  ident: 10.1016/j.ehj.2016.01.002_b0075
  article-title: Interpretation of echocardiographic measurements: a call for standardization
  publication-title: Am Heart J
  doi: 10.1016/S0002-8703(00)90084-X
– volume: 15
  start-page: 253
  year: 2014
  ident: 10.1016/j.ehj.2016.01.002_b0020
  article-title: Normal reference ranges for echocardiography: do we really need more?
  publication-title: Eur Heart J Cardiovasc Imaging
  doi: 10.1093/ehjci/jet265
– volume: 14
  start-page: 303
  year: 2013
  ident: 10.1016/j.ehj.2016.01.002_b0010
  article-title: Normal reference ranges for echocardiography: rationale, study design, and methodology (NORRE study)
  publication-title: Eur Heart J Cardiovasc Imaging
  doi: 10.1093/ehjci/jet008
– volume: 57
  start-page: 450
  year: 1986
  ident: 10.1016/j.ehj.2016.01.002_b0055
  article-title: Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings
  publication-title: Am J Cardiol
  doi: 10.1016/0002-9149(86)90771-X
– volume: 35
  start-page: 1327
  year: 2014
  ident: 10.1016/j.ehj.2016.01.002_b0065
  article-title: Echocardiographic measurements of cardiac dimensions correlate better with body length than with body weight or body surface area
  publication-title: Pediatr Cardiol
  doi: 10.1007/s00246-014-0932-4
– volume: 23
  start-page: 685
  year: 2010
  ident: 10.1016/j.ehj.2016.01.002_b0045
  publication-title: J Am Soc Echocardiogr
  doi: 10.1016/j.echo.2010.05.010
– volume: 28
  start-page: 1
  year: 2015
  ident: 10.1016/j.ehj.2016.01.002_b0025
  article-title: Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging
  publication-title: J Am Soc Echocardiogr
  doi: 10.1016/j.echo.2014.10.003
– volume: 18
  start-page: 191
  year: 2005
  ident: 10.1016/j.ehj.2016.01.002_b0095
  article-title: Normalization for body size and population-attributable risk of left ventricular hypertrophy: the strong heart study
  publication-title: Am J Hypertens
  doi: 10.1016/j.amjhyper.2004.08.032
– volume: 317
  start-page: 1098
  year: 1987
  ident: 10.1016/j.ehj.2016.01.002_b0040
  article-title: Simplified calculation of body surface area
  publication-title: N Engl J Med
  doi: 10.1056/NEJM198710223171717
– volume: 6
  start-page: 1073
  year: 2013
  ident: 10.1016/j.ehj.2016.01.002_b0080
  article-title: Size matters! Impact of age, sex, height, and weight on the normal heart size
  publication-title: Circ Cardiovasc Imaging
  doi: 10.1161/CIRCIMAGING.113.000690
– volume: 14
  start-page: 601
  issue: 6
  year: 2001
  ident: 10.1016/j.ehj.2016.01.002_b0035
  article-title: Reference values for echocardiographic measurements in urban and rural populations of differing ethnicity: the strong heart study
  publication-title: J Am Soc Echocardiogr
  doi: 10.1067/mje.2001.113258
– volume: 72
  start-page: 1859
  year: 2008
  ident: 10.1016/j.ehj.2016.01.002_b0030
  article-title: Normal values of echocardiographic parameters in relation to age in a healthy Japanese population: the JAMP study
  publication-title: Circ J
  doi: 10.1253/circj.CJ-08-0171
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Snippet Normal values for echocardiographic measurements are widely based on cohorts from North American populations. Differences have been shown to exist that could...
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SubjectTerms Echocardiography
Egypt
Normal
Reference value
Title Normal reference values of echocardiographic measurements in young Egyptian adults
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