TY - JOUR

T1 - Reference values for left ventricular dimensions, systolic and diastolic function

T2 - a study from the Amazon Basin of Brazil

AU - Wegener, Alma

AU - Kaagaard, Molly D.

AU - Gomes, Laura Cordeiro

AU - Holm, Anna Engell

AU - Matos, Luan O.

AU - Lima, Karine O.

AU - Vieira, Isabelle V. M.

AU - de Souza, Rodrigo Medeiros

AU - Olsen, Flemming Javier

AU - Farias Marinho, Claudio Romero

AU - Biering-Sorensen, Tor

AU - Silvestre, Odilson M.

AU - Brainin, Philip

PY - 2022

Y1 - 2022

N2 - Country- and ethnicity-specific reference values for echocardiographic parameters are necessary for decision making. No prior studies have examined reference values in adults from the Amazon Basin of Brazil. We performed echocardiographic examinations in 290 healthy adults (mean age 37 +/- 14 years, 40% male) from the Brazilian Amazon. Left ventricular (LV) dimensions and volumes were obtained and indexed to body surface area. We also assessed systolic (LV ejection fraction [LVEF] and global longitudinal strain [GLS]) and diastolic function. LV dimensions and volumes were larger in males compared to females, but after indexation only volumes remained larger (P < 0.001 for all). Parameters of systolic function, were significantly greater in females (LVEF 50 to 68%, GLS - 17 to - 24%) than in males (LVEF 50 to 67%, GLS - 15 to - 23%, P < 0.05). Upper limits of normality for cardiac dimensions (indexed and non-indexed) were markedly higher compared to contemporary guidelines (American Society of Echocardiography) and the Brazilian subgroup in the World Alliance Society of Echocardiography (WASE). Lower limit of normality for LVEF (both sex 50%) and upper limit of normality for the left atrial volume index (LAVI) (male: 31 mL/m(2), female: 25 mL/m(2)) were within normal range but slightly lower compared to guidelines and the WASE study. Other diastolic parameters, including E/A-ratio, E/e' ratio and peak tricuspid regurgitation velocity were compatible with present recommendations. Normal reference ranges of echocardiographic parameters in healthy adults from the Brazilian Amazon Basin may be different compared to international guidelines and data from other regions of Brazil. This applies specifically for LVEF and LAVI.

AB - Country- and ethnicity-specific reference values for echocardiographic parameters are necessary for decision making. No prior studies have examined reference values in adults from the Amazon Basin of Brazil. We performed echocardiographic examinations in 290 healthy adults (mean age 37 +/- 14 years, 40% male) from the Brazilian Amazon. Left ventricular (LV) dimensions and volumes were obtained and indexed to body surface area. We also assessed systolic (LV ejection fraction [LVEF] and global longitudinal strain [GLS]) and diastolic function. LV dimensions and volumes were larger in males compared to females, but after indexation only volumes remained larger (P < 0.001 for all). Parameters of systolic function, were significantly greater in females (LVEF 50 to 68%, GLS - 17 to - 24%) than in males (LVEF 50 to 67%, GLS - 15 to - 23%, P < 0.05). Upper limits of normality for cardiac dimensions (indexed and non-indexed) were markedly higher compared to contemporary guidelines (American Society of Echocardiography) and the Brazilian subgroup in the World Alliance Society of Echocardiography (WASE). Lower limit of normality for LVEF (both sex 50%) and upper limit of normality for the left atrial volume index (LAVI) (male: 31 mL/m(2), female: 25 mL/m(2)) were within normal range but slightly lower compared to guidelines and the WASE study. Other diastolic parameters, including E/A-ratio, E/e' ratio and peak tricuspid regurgitation velocity were compatible with present recommendations. Normal reference ranges of echocardiographic parameters in healthy adults from the Brazilian Amazon Basin may be different compared to international guidelines and data from other regions of Brazil. This applies specifically for LVEF and LAVI.

KW - Normal values

KW - Left ventricular dimension

KW - Left ventricular volume

KW - Systolic function

KW - Diastolic function

KW - Brazil

KW - Echocardiography

KW - CARDIAC CHAMBER QUANTIFICATION

KW - WORLD ALLIANCE SOCIETIES

KW - EUROPEAN ASSOCIATION

KW - AMERICAN SOCIETY

KW - ECHOCARDIOGRAPHY

KW - SIZE

KW - AGE

KW - RECOMMENDATIONS

KW - UPDATE

KW - ADULTS

U2 - 10.1007/s10554-021-02475-x

DO - 10.1007/s10554-021-02475-x

M3 - Journal article

C2 - 34807316

VL - 38

SP - 813

EP - 822

JO - International Journal of Cardiovascular Imaging

JF - International Journal of Cardiovascular Imaging

SN - 1569-5794

IS - 4

ER -