Real-time three-dimensional echocardiographic left heart parameters in healthy indian adults

Abstract

Objective: Cardiac chamber dimensions are race and anthropometry dependent. We determined the age and gender specific 3-Dimensional echocardiographic (3DE) reference values for dimensions and function of left ventricle (LV) and left atrium (LA) in normal Indian adults.

Methods: This single center prospective study enrolled 133 adult Indians free of heart disease and/or hypertensions, subjecting them to 3DE measurements of left atrial (LA) & left ventricular (LV) volumes, function and left ventricular mass (LVM). The higher limits of normal cut-offs were determined for these parameters and their dependency on age, gender and anthropometry were analyzed.

Results: The body surface area (BSA) corrected higher limit cut-offs were: 59.37ml/m² for LV end diastolic volume (59.19ml/m² and 59.61ml/m² for men and women, respectively; P=NS); 23.48ml/m² for LV end systolic volume (23.27ml/m2 and 23.11ml/m² for men and women, P=NS). Mean LVEF was 64.79%±7.26 (62.99%±6.51 and 67.05%±7.58 in men and women, P=NS). Men had higher LVM than women (119.79g±23.95 vs. 103.26g±23.76, P<0.001), this difference disappeared after BSA indexing. The higher limit cut-offs for normal LA volumes were 20.49ml for minimum volume (21.18ml and 19.46ml for men and women, P=NS) and 39.76ml for maximum volume (39.60ml and 40.03ml in men and women, P=NS). The parameters were smaller compared to western populations but the differences attenuated after BSA indexing.

Conclusions: The study reports normal 3DE parameters of size and function of left heart chambers in Indians.

Keywords: Left atrial emptying fraction; Left atrial volume; Left ventricular end diastolic volume; Left ventricular end systolic volume; Three-dimensional echocardiography.

Fig. 1

3D-echocardiographic determination of left ventricle volumes and function. 4-chamber (top left), 2-chamber (top right) and short axis (bottom left) planes showing semi-automatic tracing of endocardial borders and resultant 3D cast of the LV cavity (bottom right).

Fig. 2

Intra-observer variability in assessment of LV and LA parameters as analyzed by Bland Altman method (left) and Pearson’s correlation method (right).