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1. A meta-analysis of echocardiographic measurements of the left heart for the development of normative reference ranges in a large international cohort: the EchoNoRMAL study

Author

Anderson T., Dyck J., Ezekowitz J. A., Chirinos J. A., De Buyzere M. L., Gillebert T. C., Rietzschel E., Segers P., Van Daele C. M., Doughty R. N., Poppe K. K., Walsh H. A., Whalley G. A., Chen P. C., Chien K. L., Lin H. J., Su, T. C., Mogelvang R., Jensen J. S., Chadha D. S., Goel K., Misra A., Detrano R., Cameron V., Richards A. M., Troughton R., Di Pasquale P., Paterna S., Duzenli M. A., Hobbs F. D. R., Davies M. K., Davis R. C., Roalfe A., Calvert M., Freemantle N., Gill, P. S., Lip G. Y. H., Kuznetsova T., Staessen J. A., Dargie H. J., Ford I., McDonagh T. A., McMurray J. J. V., Grossman E., Galasko G., Lahiri A., Senior R., Blauwet L., Sliwa K., Stewart S., Brown A., Carrington M., Krum H., McGrady M., Zeitz C., Dalen H., Hansen H. E. M., Støylen A., Thorstensen A., Daimon M., Watanabe H., Yoshikawa J., Fukuda S., Kim H. K., Leung N. K. W., Linhart A., Chahal N., Chambers J. C., Kooner J., Davies J., Loke I., Ng, L., Squire I. B., Aune E., Otterstad J. E., Leung D. Y., Ng A. C. T., Ojji D., Arnold L., Coffey S., D'Arcy J., Hammond C., Mabbett C., Lima C., Loudon M., Pinheiro N., Prendergast B., Reynolds R., Badano L. P., Muraru D., Peluso D., Dal Bianco L., Petrovic D. J., Petrovic J., Schvartzman P., Fuchs F. D., Katova T., Simova I., Kaku K., Takeuchi M., Boyd A., Thomas L., Chia E. M., Schirmer H., Angelo L. C., Pereira A. C., Krieger J. E., Mill J. G., Rodrigues S. L., Muiesan M. L., Paini A., Rosei E. A., Salvetti M., Gardin J. M., Nagueh S. F., Altman D., Perera R., Triggs C. M., Au Yeung H., Beans Picon G. A., IZZO, RAFFAELE, DE LUCA, NICOLA, TRIMARCO, BRUNO, DE SIMONE, GIOVANNI, Anderson, T., Dyck, J., Ezekowitz, J. A., Chirinos, J. A., De Buyzere, M. L., Gillebert, T. C., Rietzschel, E., Segers, P., Van Daele, C. M., Doughty, R. N., Poppe, K. K., Walsh, H. A., Whalley, G. A., Izzo, Raffaele, DE LUCA, Nicola, Trimarco, Bruno, DE SIMONE, Giovanni, Chen, P. C., Chien, K. L., Lin, H. J., Su, T. C., Mogelvang, R., Jensen, J. S., Chadha, D. S., Goel, K., Misra, A., Detrano, R., Cameron, V., Richards, A. M., Troughton, R., Di Pasquale, P., Paterna, S., Duzenli, M. A., Hobbs, F. D. R., Davies, M. K., Davis, R. C., Roalfe, A., Calvert, M., Freemantle, N., Gill, P. S., Lip, G. Y. H., Kuznetsova, T., Staessen, J. A., Dargie, H. J., Ford, I., Mcdonagh, T. A., Mcmurray, J. J. V., Grossman, E., Galasko, G., Lahiri, A., Senior, R., Blauwet, L., Sliwa, K., Stewart, S., Brown, A., Carrington, M., Krum, H., Mcgrady, M., Zeitz, C., Dalen, H., Hansen, H. E. M., Støylen, A., Thorstensen, A., Daimon, M., Watanabe, H., Yoshikawa, J., Fukuda, S., Kim, H. K., Leung, N. K. W., Linhart, A., Chahal, N., Chambers, J. C., Kooner, J., Davies, J., Loke, I., Ng, L., Squire, I. B., Aune, E., Otterstad, J. E., Leung, D. Y., Ng, A. C. T., Ojji, D., Arnold, L., Coffey, S., D'Arcy, J., Hammond, C., Mabbett, C., Lima, C., Loudon, M., Pinheiro, N., Prendergast, B., Reynolds, R., Badano, L. P., Muraru, D., Peluso, D., Dal Bianco, L., Petrovic, D. J., Petrovic, J., Schvartzman, P., Fuchs, F. D., Katova, T., Simova, I., Kaku, K., Takeuchi, M., Boyd, A., Thomas, L., Chia, E. M., Schirmer, H., Angelo, L. C., Pereira, A. C., Krieger, J. E., Mill, J. G., Rodrigues, S. L., Muiesan, M. L., Paini, A., Rosei, E. A., Salvetti, M., Gardin, J. M., Nagueh, S. F., Altman, D., Perera, R., Triggs, C. M., Au Yeung, H., Beans Picon, G. A., and Badano, L

Subjects
Male, Pediatrics, International Cooperation, Left, Ethnic Group, Sex Factor, Ventricular Function, Left, Heart Ventricle, Cohort Studies, Echocardiography, Meta-analysis, Reference ranges, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Atrial Function, Left, Ethnic Groups, Female, Heart Atria, Heart Ventricles, Humans, Middle Aged, Reference Standards, Sex Factors, Young Adult, Cardiology and Cardiovascular Medicine, Radiology, Nuclear Medicine and Imaging, Nuclear Medicine and Imaging, 80 and over, Ethnicity, Ventricular Function, Age Factor, Young adult, education.field_of_study, General Medicine, Atrial Function, Parametric Regression Method, Cohort, Cardiology, Radiology, Human, Cohort study, medicine.medical_specialty, Population, Internal medicine, medicine, Meta-analysi, Radiology, Nuclear Medicine and imaging, education, business.industry, Reference range, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Quantile regression, Reference Standard, Normative, Cohort Studie, business
Abstract

Aim: To develop age-, sex-, and ethnic-Appropriate normative reference ranges for standard echocardiographic measurements of the left heart by combining echocardiographic measurements obtained from adult volunteers without clinical cardiovascular disease or significant cardiovascular risk factors, from multiple studies around the world.Methods and results: The Echocardiographic Normal Ranges Meta-Analysis of the Left heart (EchoNoRMAL) collaboration was established and population-based data sets of echocardiographic measurements combined to perform an individual person data meta-Analysis. Data from 43 studies were received, representing 51 222 subjects, of which 22 404 adults aged 18-80 years were without clinical cardiovascular or renal disease, hypertension or diabetes. Quantile regression or an appropriate parametric regression method will be used to derive reference values at the 5th and 95th centile of each measurement against age. Conclusion: This unique data set represents a large, multi-ethnic cohort of subjects resident in a wide range of countries. The resultant reference ranges will have wide applicability for normative data based on age, sex, and ethnicity. © The Author 2013.

Published
2013
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2. Ethnic-specific normative reference values for echocardiographic la and LV size, LV mass, and systolic function: The EchoNoRMAL study

Author

Poppe, K. K., Doughty, R. N., Gardin, J. M., Nagueh, S. F., Whalley, G. A., Cameron, V., Chadha, D. S., Chien, K. L., Detrano, R., Akif Duzenli, M., Ezekowitz, J., Di Pasquale, P., Mogelvang, R., Altman, D. G., Perera, R., Triggs, C. M., Au Yeung, H., Beans Picon, G. A., Anderson, T., Dyck, J., Ezekowitz, J. A., Chirinos, J. A., De Buyzere, M. L., Gillebert, T. C., Rietzschel, E., Segers, P., Van daele, C. M., Walsh, H. A., Izzo, R., De Luca, N., Trimarco, B., De Simone, G., Goel, K., Misra, A., Chen, P. C., Lin, H. J., T. C., Su, Richards, A. M., Troughton, R., Skov Jensen, J., Paterna, S., Hobbs, F. D. R., Davies, M. K., Davis, R. C., Roalfe, A., Calvert, M., Freemantle, N., Gill, P. S., Lip, G. Y. H., Kuznetsova, T., Staessen, J. A., Dargie, H. J., Ford, I., Mcdonagh, T. A., Mcmurray, J. J. V., Grossman, E., Galasko, G., Lahiri, A., Senior, R., Brown, A., Carrington, M., Krum, H., Mcgrady, M., Stewart, S., Zeitz, C., Blauwet, L., Sliwa, K., Dalen, H., Moelmen Hansen, H. E., Stoylen, A., Thorstensen, A., Daimon, M., Watanabe, H., Yoshikawa, J., Fukuda, S., Kim, H. K., Leung, N. K. W., Linhart, A., Chahal, N., Chambers, J. C., Kooner, J., Davies, J., Loke, I., Ng, L., Squire, I. B., Aune, E., Otterstad, J. E., Leung, D. Y., A. C. T., Ng, Ojji, D., Arnold, L., Coffey, S., D'Arcy, J., Hammond, C., Mabbett, C., Lima, C., Loudon, M., Pinheiro, N., Prendergast, B., Reynolds, R., Badano, L. P., Muraru, D., Peluso, D., DAL BIANCO, Laura, Petrovic, D. J., Petrovic, J., Schvartzman, P., Fuchs, F. D., Katova, T., Simova, I., Kaku, K., Takeuchi, M., Boyd, A., Chia, E. M., Thomas, L., Schirmer, H., Angelo, L. C., Pereira, A. C., Krieger, J. E., Mill, J. G., Rodrigues, S. L., Muiesan, Maria Lorenza, Paini, Anna, AGABITI ROSEI, Enrico, and Salvetti, Massimo

Subjects
Nuclear Medicine and Imaging, echocardiography, ethnic appropriate, reference ranges, Cardiology and Cardiovascular Medicine, Radiology, Nuclear Medicine and Imaging, Radiology
Published
2015

3. Modest opposite associations of endogenous testosterone and oestradiol with left ventricular remodelling and function in healthy middle-aged men.

Author

Ruige, J. B., Rietzschel, E. R., De Buyzere, M. L., Bekaert, S., Segers, P., De Bacquer, D., De Backer, G., Gillebert, T. C, and Kaufman, J.-M.

Subjects
*TESTOSTERONE, *CARDIOVASCULAR diseases, *ESTRADIOL, *ECHOCARDIOGRAPHY, *DOPPLER effect, *REGRESSION analysis, *HEART beat, *TRIGLYCERIDES
Abstract

Summary In healthy middle-aged men, endogenous testosterone does not seem to increase risk for cardiovascular disease (CVD). One explanation might be a differential effect of testosterone, and another, interference with oestradiol with respect to specific cardiovascular functions. To investigate these possibilities, we evaluated in a cross-sectional population of 1223 healthy men, aged 46 (6) years, associations between endogenous testosterone, oestradiol and left ventricular structure and function (echocardiography). Testosterone was inversely associated with ejection fraction (EF) and with more sensitive systolic tissue Doppler imaging indices. Oestradiol was positively associated with EF. These associations were confirmed by linear regression analyses, and consistent for calculated free as well as for total sex steroid concentrations. Standardized regression coefficients were −0.13 for testosterone ( P < 0.01) and 0.12 for oestradiol ( P < 0.01) for the association with EF, in a model which included height, waist circumference, triglycerides, glucose, systolic blood pressure, drug-treated hypertension, heart rate, haematocrit, current smoking, serum sampling time, age and excessive alcohol use. The study suggests an opposite link, albeit modestly, of testosterone and oestradiol with left ventricle systolic function in healthy middle-aged men. The finding provides a partial explanation for the overall neutral effect on CVD of testosterone in healthy middle-aged men. [ABSTRACT FROM AUTHOR]

Published
2011
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4. Noninvasive assessment of left ventricular and myocardial contractility in middle-aged men and women: disparate evolution above the age of 50?

Author

Claessens, T. E., Rietzschel, E. R., De Buyzere, M. L., De Bacquer, D., De Backer, G., Gillebert, T. C., Verdonck, P. R., and Segers, P.

Subjects
*CARDIAC contraction, *CARDIOMYOPATHIES, *ECHOCARDIOGRAPHY, *BLOOD pressure, *ARM blood-vessels, *MIDDLE-aged persons, *PHYSIOLOGY
Abstract

End-systolic elastance (Ees) is a frequently used index of left ventricular (LV) contractility. However, because of its inherent dependence on LV geometry, Ees cannot be used to compare myocardial contractile state between ventricles with different geometries, which is the case in any cross-sectional study. Various normalization methods for Ees have been proposed in the literature, but a standardized method is still lacking. In this study, we introduced a novel alternative normalization technique and compared it with three previously suggested methods. We tested all normalization methods to assess the age- and sex-related differences in myocardial contractility in a large population sample of 2,184 middle-aged (ages, 35-55 yr) untreated subjects free from overt cardiovascular disease. Ventricular contractility Ees was determined using a previously validated noninvasive single-beat method, based on two-dimensional echocardiographic and brachial blood pressure measurements. Myocardial contractility was estimated as 1) Ees·end-diastolic volume (EDV); 2) Ees·LV mass (LVM); 3) 0.433·Ees,LVM/relative wall thickness (RWT), based on a theoretical LV model; and 4) 0.0941·Ees·LVM0.455·RWT-0.159, a novel semiempirical expression derived in this study. Because of the difference in their underlying assumptions, the various myocardial contractility indexes do not provide consistent information with respect to sex differences. Despite these discrepancies, it was found that myocardial contractility in women appears to be better preserved after the age of 50 yr compared with that in men. The physiological mechanisms behind this potentially clinically important phenomenon at population level require further investigation. [ABSTRACT FROM AUTHOR]

Published
2007
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5. Ethnic-Specific Normative Reference Values for Echocardiographic LA and LV Size, LV Mass, and Systolic Function The EchoNoRMAL Study

Author

Poppe KK, Doughty RN, Gardin JM, Hobbs FD, McMurray JJ, Nagueh SF, Senior R, Thomas L, Whalley GA, Aune E, Brown A, Badano LP, Cameron V, Chadha DS, Chahal N, Chien KL, Daimon M, Dalen H, Detrano R, Akif Duzenli M, Ezekowitz J, Di Pasquale P, Fukuda S, Gill PS, Grossman E, Kim HK, Kuznetsova T, Leung NK, Linhart A, McDonagh TA, McGrady M, Mill JG, Mogelvang R, Muiesan ML, Ng AC, Ojji D, Otterstad JE, Petrovic DJ, Prendergast B, Rietzschel E, Schirmer H, Schvartzman P, Simova I, Sliwa K, Stewart S, Squire IB, Takeuchi M, Altman DG, Perera R, Triggs CM, Au Yeung H, Beans Picón GA, Anderson T, Dyck J, Ezekowitz JA, Chirinos JA, De Buyzere ML, Gillebert TC, Segers P, Van Daele CM, Walsh HA, de Simone G, Goel K, Misra A, Chen PC, Lin HJ, Su TC, Richards AM, Troughton R, Skov Jensen J, Paterna S, Davies MK, Davis RC, Roalfe A, Calvert M, Freemantle N, Lip GY, Staessen JA, Dargie HJ, Ford I, Galasko G, Lahiri A, Carrington M, Krum H, Zeitz C, Blauwet L, Moelmen Hansen HE, Støylen A, Thorstensen A, Watanabe H, Yoshikawa J, Chambers JC, Kooner J, Davies J, Loke I, Ng L, Leung DY, Arnold L, Coffey S, d'Arcy J, Hammond C, Mabbett C, Lima C, Loudon M, Pinheiro N, Reynolds R, Muraru D, Peluso D, Dal Bianco L, Petrovic J, Fuchs FD, Katova T, Kaku K, Boyd A, Chia EM, Angelo LC, Pereira AC, Krieger JE, Rodrigues SL, Paini A, Agabiti Rosei E, Salvetti M., DE SIMONE, GIOVANNI, IZZO, RAFFAELE, DE LUCA, NICOLA, TRIMARCO, BRUNO, Poppe, Kk, Doughty, Rn, Gardin, Jm, Hobbs, Fd, Mcmurray, Jj, Nagueh, Sf, Senior, R, Thomas, L, Whalley, Ga, Aune, E, Brown, A, Badano, Lp, Cameron, V, Chadha, D, Chahal, N, Chien, Kl, Daimon, M, Dalen, H, Detrano, R, Akif Duzenli, M, Ezekowitz, J, DE SIMONE, Giovanni, Di Pasquale, P, Fukuda, S, Gill, P, Grossman, E, Kim, Hk, Kuznetsova, T, Leung, Nk, Linhart, A, Mcdonagh, Ta, Mcgrady, M, Mill, Jg, Mogelvang, R, Muiesan, Ml, Ng, Ac, Ojji, D, Otterstad, Je, Petrovic, Dj, Prendergast, B, Rietzschel, E, Schirmer, H, Schvartzman, P, Simova, I, Sliwa, K, Stewart, S, Squire, Ib, Takeuchi, M, Altman, Dg, Perera, R, Triggs, Cm, Au Yeung, H, Beans Picón, Ga, Anderson, T, Dyck, J, Ezekowitz, Ja, Chirinos, Ja, De Buyzere, Ml, Gillebert, Tc, Segers, P, Van Daele, Cm, Walsh, Ha, Izzo, Raffaele, DE LUCA, Nicola, Trimarco, Bruno, de Simone, G, Goel, K, Misra, A, Chen, Pc, Lin, Hj, Su, Tc, Richards, Am, Troughton, R, Skov Jensen, J, Paterna, S, Davies, Mk, Davis, Rc, Roalfe, A, Calvert, M, Freemantle, N, Lip, Gy, Staessen, Ja, Dargie, Hj, Ford, I, Galasko, G, Lahiri, A, Carrington, M, Krum, H, Zeitz, C, Blauwet, L, Moelmen Hansen, He, Støylen, A, Thorstensen, A, Watanabe, H, Yoshikawa, J, Chambers, Jc, Kooner, J, Davies, J, Loke, I, Ng, L, Leung, Dy, Arnold, L, Coffey, S, D'Arcy, J, Hammond, C, Mabbett, C, Lima, C, Loudon, M, Pinheiro, N, Reynolds, R, Muraru, D, Peluso, D, Dal Bianco, L, Petrovic, J, Fuchs, Fd, Katova, T, Kaku, K, Boyd, A, Chia, Em, Angelo, Lc, Pereira, Ac, Krieger, Je, Rodrigues, Sl, Paini, A, Agabiti Rosei, E, and Salvetti, M.

Subjects
echocardiography, reference ranges, ethnic appropriate
Abstract

ObjectivesThis study sought to derive age-, sex-, and ethnic-appropriate adult reference values for left atrial (LA) and left ventricular (LV) dimensions and volumes, LV mass, fractional shortening, and ejection fraction (EF) derived from geographically diverse population studies.BackgroundThe current recommended reference values for measurements from echocardiography may not be suitable to the diverse world population to which they are now applied.MethodsPopulation-based datasets of echocardiographic measurements from 22,404 adults without clinical cardiovascular or renal disease, hypertension, or diabetes were combined in an individual person data meta-analysis. Quantile regression was used to derive reference values at the 95th percentile (upper reference value [URV]) and fifth percentile (lower reference value [LRV]) of each measurement against age (treated as linear), separately within sex and ethnic groups.ResultsThe URVs for left ventricular end-diastolic volume (LVEDV), LV end-systolic volume, and LV stroke volume (SV) were highest in Europeans and lowest in South Asians. Important sex and ethnic differences remained after indexation by body surface area or height for these measurements, as well as for the LRV for SV. LVEDV and SV decreased with increasing age for all groups. Importantly, the LRV for EF differed by ethnicity; there was a clear apparent difference between Europeans and Asians. The URVs for LV end-diastolic diameter and LV end-systolic diameter were higher for Europeans than those for East Asian, South Asian, and African people, particularly among men. Similarly, the URVs for LA diameter and volume were highest for Europeans.ConclusionsSex- and/or ethnic-appropriate echocardiographic reference values are indicated for many measurements of LA and LV size, LV mass, and EF. Reference values for LV volumes and mass also differ across the age range.

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6. Validation of a new automated IMT measurement algorithm.

Author

Vermeersch, S. J., Rietzschel, E. R., De Buyzere, M. L., Van Bortel, L. M., D'Asseler, Y., Gillebert, T. C., Verdonck, P. R., and Segers, P.

Subjects
*MEDICAL imaging systems, *MEDICAL equipment, *DIAGNOSTIC imaging, *ULTRASONIC imaging, *ECHOCARDIOGRAPHY
Abstract

Several large-scale studies have confirmed that intima—media thickness (IMT) values can be used to accurately identify cardiovascular risk. With the advent of more accurate ultrasonographic measurement applications, there has been a growing interest in validated, clinically applicable tools for performing automated IMT measurements. This study aims to validate a new semi-automated IMT detection algorithm, supplied by GE Vingmed Ultrasound, by comparing it with IMT measurements performed manually at the common carotid artery. [ABSTRACT FROM AUTHOR]

Published
2007
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