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102. MEASUREMENTS AND APPLICATIONS CATEGORIZATION OF THE METHODS FOR RISK ASSESSMENT.

Author

Vladimirov, Lyubomir and Hristova, Krasimira

Abstract

PURPOSE: The purpose of this work is to categorize the methods to assess the risk to be the basis for creating catalogs for their customers. To achieve a study on developing and using methods previously. Basic features are defined on the basis of which the classification is made. A version of the catalog of the studied methods. MATERIAL AND METHODS: 1. MATERIAL: 144 methods of risk assessment applied in world practice. 2. METHODS: - Study of existing methods; - Define the basic features for classification; - Cataloged the investigated methods. EXPECTED RESULTS: Categorization methods for risk assessment and measurability application that can be used as an initial phase of construction of an integrated catalog of custom methods. CONCLUSIONS: 1. By bibliographic methods of risk assessment supports the implementation of international standard ISO 31000:2009 and expanded set of methods that are recommended by the standard ISO 31010:2009. 2. The categorization presented in tabular form creates visual features for easy orientation and quick selection of the appropriate method for risk assessment. This format is suitable for the construction of expert information system to be developed. [ABSTRACT FROM AUTHOR]

Published
2013

103. Correlation between non-invasive myocardial work indices and main parameters of systolic and diastolic function

Author

Arnaud Ancion, Ciro Santoro, Roberto M. Lang, Krasimira Hristova, Dragos Vinereanu, Patrizio Lancellotti, Marie Moonen, Maurizio Galderisi, George Kacharava, José Luis Zamorano, Daniele Barone, Andreas Hagendorff, Julien Magne, Christophe Martinez, Bernard Cosyns, Nico Van de Veire, Monica Baroni, Tolga Ozyigit, Toshimitsu Tsugu, Nuno Cardim, Raluca Elena Dulgheru, Ralph Stephan von Bardeleben, Gonzalo de la Morena, Concetta Zito, Scipione Carerj, Luigi P. Badano, Elena Galli, Martin Penicka, George Athanassopoulos, Bogdan A. Popescu, Erwan Donal, Jose David Rodrigo Carbonero, Adriana Postolache, Federica Ilardi, Monica Rosca, Teresa López, Andreea Calin, Marianna Cicenia, Tadafumi Sugimoto, Roberta Manganaro, Stella Marchetta, Clinical sciences, Cardio-vascular diseases, Cardiology, Manganaro, Roberta, Marchetta, Stella, Dulgheru, Raluca, Sugimoto, Tadafumi, Tsugu, Toshimitsu, Ilardi, Federica, Cicenia, Marianna, Ancion, Arnaud, Postolache, Adriana, Martinez, Christophe, Kacharava, George, Athanassopoulos, George D, Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andrea, Hristova, Krasimira, Lopez, 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, Drago, Zamorano, Jose Lui, 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, Lancellotti, Patrizio, Centre Hospitalier Universitaire de Liège (CHU-Liège), Service de cardiologie [Liège], CHU de Liège-Domaine Universitaire du Sart Tilman, Universität Leipzig [Leipzig], Hospital Univeristario Virgen de la Arrixaca, Johannes Gutenberg - Universität Mainz (JGU), University and Emergency Hospital, Universidad de Alcalá - University of Alcalá (UAH), Service de cardiologie [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Academisch Ziekenhuis Vrije Universiteit Brussel, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Messina, Università degli studi di Napoli Federico II, GE Healthcare and Philips Healthcare, Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service de cardiologie et maladies vasculaires [CHU de Rennes], Manganaro, R, Marchetta, S, Dulgheru, R, Sugimoto, T, Tsugu, T, Ilardi, F, Cicenia, M, Ancion, A, Postolache, A, Martinez, C, Kacharava, G, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, Lopez, T, de la Morena, G, Popescu, B, Penicka, M, Ozyigit, T, Rodrigo Carbonero, J, van de Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Rosca, M, Calin, A, Moonen, M, Magne, J, Cosyns, B, Galli, E, Donal, E, Carerj, S, Zito, C, Santoro, C, Galderisi, M, Badano, L, Lang, R, and Lancellotti, P

Subjects
Adult, Male, medicine.medical_specialty, Systole, adult echocardiography, Diastole, Speckle tracking echocardiography, 030204 cardiovascular system & hematology, myocardial strain, myocardial work, speckle tracking echocardiography, Ventricular Function, Left, Correlation, Ventricular Dysfunction, Left, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Ejection fraction, business.industry, Work (physics), Stroke Volume, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, General Medicine, Middle Aged, medicine.anatomical_structure, Blood pressure, Echocardiography, Ventricle, Cardiology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Cardiology and Cardiovascular Medicine, business
Abstract

Aims The present study sought to evaluate the correlation between indices of non-invasive myocardial work (MW) and left ventricle (LV) size, traditional and advanced parameters of LV systolic and diastolic function by 2D echocardiography (2DE). 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 LV pressure-strain loops using custom software. Peak LV pressure was estimated non-invasively from brachial artery cuff pressure. LV size, parameters of systolic and diastolic function and ventricular-arterial coupling were measured by echocardiography. As advanced indices of myocardial performance, global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained. On multivariable analysis, GWI was significantly correlated with GLS (standardized beta-coefficient = −0.23, P Conclusion The non-invasive MW indices show a good correlation with traditional 2DE parameters of myocardial systolic function and myocardial strain.

Published
2020

104. Multicentric Atrial Strain COmparison between Two Different Modalities: MASCOT HIT Study

Author

Roberta Esposito, Andreea Motoc, Giuseppe Sammarco, Tomas Lapinskas, Sorina Mihaila Baldea, Tor Biering-Sørensen, Žanna Pičkure, Svetlin Netkov Tsonev, István Szabó, Anja Zupan Mežnar, Gergely Ágoston, Giovanna Di Giannuario, Katja Ažman Juvan, Giovanni Benfari, Guillem Casas, Artem Kalinin, Sergio Mondillo, Flemming Javier Olsen, Alessandro Salustri, Dragos Vinereanu, Savvas Loizos, Elena Galli, Augustine Coisne, Marcelo Haertel Miglioranza, Roberta Ancona, Jolanta Vaskelyte, Mihaela Maria Opris, Erwan Donal, Gerolamo Sibilio, Maria Concetta Pastore, Ciro Santoro, Galal Abushahba, Laura Galian-Gay, Salvatore Comenale Pinto, Vlatka Rešković Lukšić, Błażej Michalski, Maurizio Galderisi, Constantinos Hristou Papadopoulos, Riitta Paakkanen, Federica Ilardi, Dosen Dejan, Bernard Cosyns, R Dulgheru, Amandine Coppin, Martin Penicka, Doralisa Morrone, Dan Octavian Nistor, Krasimira Hristova, Asim Katbeh, Giulia Elena Mandoli, Fiorella Devito, Leonardo Griseli, Philippe Mortelmans, Thor Edvardsen, Caroline M. Van De Heyning, Bogdan A. Popescu, Karolina Kupczyńska, Matteo Cameli, Iacopo Fabiani, Julien Magne, Denisa Muraru, Cameli, Matteo, Miglioranza, Marcelo Haertel, Magne, Julien, Mandoli, Giulia Elena, Benfari, Giovanni, Ancona, Roberta, Sibilio, Gerolamo, Reskovic Luksic, Vlatka, Dejan, Dosen, Griseli, Leonardo, Van De Heyning, Caroline M., Mortelmans, Philippe, Michalski, Blazej, Kupczynska, Karolina, Di Giannuario, Giovanna, Devito, Fiorella, Dulgheru, Raluca, Ilardi, Federica, Salustri, Alessandro, Abushahba, Galal, Morrone, Doralisa, Fabiani, Iacopo, Penicka, Martin, Katbeh, Asim, Sammarco, Giuseppe, Esposito, Roberta, Santoro, Ciro, Pastore, Maria Concetta, Comenale Pinto, Salvatore, Kalinin, Artem, Pičkure, Žanna, Ažman Juvan, Katja, Zupan Mežnar, Anja, Coisne, Augustine, Coppin, Amandine, Opris, Mihaela Maria, Nistor, Dan Octavian, Paakkanen, Riitta, Biering-Sørensen, Tor, Olsen, Flemming Javier, Lapinskas, Toma, Vaškelyté, Jolanta Justina, Galian-Gay, Laura, Casas, Guillem, Motoc, Andreea Iulia, Papadopoulos, Constantinos Hristou, Loizos, Savva, Ágoston, Gergely, Szabó, Istvan, Hristova, Krasimira, Tsonev, Svetlin Netkov, Galli, Elena, Vinereanu, Drago, Mihaila Baldea, Sorina, Muraru, Denisa, Mondillo, Sergio, Donal, Erwan, Galderisi, Maurizio, Cosyns, Bernard, Edvardsen, Thor, Popescu, Bogdan A., University of Helsinki, HUS Heart and Lung Center, Helsinki University Hospital Area, Università degli Studi di Siena = University of Siena (UNISI), Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire Brugmann [Bruxelles] (CHU), University of Oslo (UiO), University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Cameli, M, Miglioranza, M, Magne, J, Mandoli, G, Benfari, G, Ancona, R, Sibilio, G, Reskovic Luksic, V, Dejan, D, Griseli, L, Van De Heyning, C, Mortelmans, P, Michalski, B, Kupczynska, K, Di Giannuario, G, Devito, F, Dulgheru, R, Ilardi, F, Salustri, A, Abushahba, G, Morrone, D, Fabiani, I, Penicka, M, Katbeh, A, Sammarco, G, Esposito, R, Santoro, C, Pastore, M, Comenale Pinto, S, Kalinin, A, Pičkure, Ž, Ažman Juvan, K, Zupan Mežnar, A, Coisne, A, Coppin, A, Opris, M, Nistor, D, Paakkanen, R, Biering-Sørensen, T, Olsen, F, Lapinskas, T, Vaškelyté, J, Galian-Gay, L, Casas, G, Motoc, A, Papadopoulos, C, Loizos, S, Ágoston, G, Szabó, I, Hristova, K, Tsonev, S, Galli, E, Vinereanu, D, Mihaila Baldea, S, Muraru, D, Mondillo, S, Donal, E, Galderisi, M, Cosyns, B, Edvardsen, T, Popescu, B, CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinical sciences, Faculty of Medicine and Pharmacy, Cardiology, and Cardio-vascular diseases

Subjects
medicine.medical_specialty, Clinical Biochemistry, CONSENSUS DOCUMENT, Speckle tracking echocardiography, 030204 cardiovascular system & hematology, GUIDELINES, RECOMMENDATIONS, Article, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, QRS complex, 0302 clinical medicine, Interquartile range, DEFORMATION, Internal medicine, Medicine, speckle tracking echocardiography, AMERICAN SOCIETY, reference point, EACVI/ASE/INDUSTRY TASK-FORCE, EUROPEAN ASSOCIATION, standardization, left atrial strain, multi-centric study, Reproducibility, Mitral regurgitation, lcsh:R5-920, business.industry, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, medicine.disease, DYSFUNCTION, Stenosis, Heart failure, 3121 General medicine, internal medicine and other clinical medicine, Cardiology, Population study, HEART-FAILURE, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Human medicine, Left atrial strain, Multi-centric study, Reference point, Standardization, Cardiology and Cardiovascular Medicine, business, lcsh:Medicine (General)
Abstract

International audience; Two methods are currently available for left atrial (LA) strain measurement by speckle tracking echocardiography, with two different reference timings for starting the analysis: QRS (QRS-LASr) and P wave (P-LASr). The aim of MASCOT HIT study was to define which of the two was more reproducible, more feasible, and less time consuming. In 26 expert centers, LA strain was analyzed by two different echocardiographers (young vs senior) in a blinded fashion. The study population included: healthy subjects, patients with arterial hypertension or aortic stenosis (LA pressure overload, group 2) and patients with mitral regurgitation or heart failure (LA volume–pressure overload, group 3). Difference between the inter-correlation coefficient (ICC) by the two echocardiographers using the two techniques, feasibility and analysis time of both methods were analyzed. A total of 938 subjects were included: 309 controls, 333 patients in group 2, and 296 patients in group 3. The ICC was comparable between QRS-LASr (0.93) and P-LASr (0.90). The young echocardiographers calculated QRS-LASr in 90% of cases, the expert ones in 95%. The feasibility of P-LASr was 85% by young echocardiographers and 88% by senior ones. QRS-LASr young median time was 110 s (interquartile range, IR, 78-149) vs senior 110 s (IR 78-155); for P-LASr, 120 s (IR 80-165) and 120 s (IR 90-161), respectively. LA strain was feasible in the majority of patients with similar reproducibility for both methods. QRS complex guaranteed a slightly higher feasibility and a lower time wasting compared to the use of P wave as the reference.

Published
2020

105. Echocardiographic reference ranges for normal left ventricular layer-specific strain: results from the EACVI NORRE study

Author

Erwan Donal, Ralph Stephan von Bardeleben, Jose David Rodrigo Carbonero, Maurizio Galderisi, Simona Sperlongano, Monica Rosca, Caroline Piette, Roberta Manganaro, Daniele Barone, Adriana Postolache, Gonzalo de la Morena, Ciro Santoro, Federica Ilardi, Teresa López, George Kacharava, Bogdan A. Popescu, Monica Baroni, Elena Galli, Patrizio Lancellotti, Toshimitsu Tsugu, Julien Magne, Yun Yun Go, Dragos Vinereanu, Nuno Cardim, Marie Moonen, Julien Tridetti, Andreea Calin, José Luis Zamorano, Tolga Ozyigit, Krasimira Hristova, Martin Penicka, Mai-Linh Nguyen Trung, Bernard Cosyns, Raluca Elena Dulgheru, Alexandra Maria Chitroceanu, Tadafumi Sugimoto, George Athanassopoulos, Luigi P. Badano, Nico Van de Veire, Roberto M. Lang, Andreas Hagendorff, Tsugu, Toshimitsu, Postolache, Adriana, Dulgheru, Raluca, Sugimoto, Tadafumi, Tridetti, Julien, Nguyen Trung, Mai-Linh, Piette, Caroline, Moonen, Marie, Manganaro, Roberta, Ilardi, Federica, Chitroceanu, Alexandra Maria, Sperlongano, Simona, Go, Yun Yun, Kacharava, George, Athanassopoulos, George D, Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andrea, Hristova, Krasimira, Lopez, 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, Drago, Zamorano, Jose Lui, Rosca, Monica, Calin, Andreea, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Santoro, Ciro, Galderisi, Maurizio, Badano, Luigi P, Lang, Roberto M, Lancellotti, Patrizio, Tsugu, T., Postolache, A., Dulgheru, R., Sugimoto, T., Tridetti, J., Trung, M. -L. N., Piette, C., Moonen, M., Manganaro, R., Ilardi, F., Chitroceanu, A. M., Sperlongano, S., Go, Y. Y., Kacharava, G., Athanassopoulos, G. D., Barone, D., Baroni, M., Cardim, N., Hagendorff, A., Hristova, K., Lopez, T., de la Morena, G., Popescu, B. A., Penicka, M., Ozyigit, T., Carbonero, J. D. R., van de Veire, N., von Bardeleben, R. S., Vinereanu, D., Zamorano, J. L., Rosca, M., Calin, A., Magne, J., Cosyns, B., Galli, E., Donal, E., Santoro, C., Galderisi, M., Badano, L. P., Lang, R. M., Lancellotti, P., Clinical sciences, Cardio-vascular diseases, Cardiology, GIGA [Université Liège], Université de Liège, CHU Limoges, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), GE Healthcare and Philips Healthcare, Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Tsugu, T, Postolache, A, Dulgheru, R, Sugimoto, T, Tridetti, J, Nguyen Trung, M, Piette, C, Moonen, M, Manganaro, R, Ilardi, F, Chitroceanu, A, Sperlongano, S, Go, Y, Kacharava, G, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, Lopez, T, de la Morena, G, Popescu, B, Penicka, M, Ozyigit, T, Rodrigo Carbonero, J, van de Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Rosca, M, Calin, A, Magne, J, Cosyns, B, Galli, E, Donal, E, Santoro, C, Galderisi, M, Badano, L, Lang, R, and Lancellotti, P

Subjects
Adult, Male, medicine.medical_specialty, adult echocardiography, deformation imaging, Heart Ventricles, 030204 cardiovascular system & hematology, Ventricular Function, Left, Reference values, 2D echocardiography, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, reference values, Healthy volunteers, medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Endocardium, Normal range, Strain (chemistry), business.industry, Myocardium, Healthy subjects, reference value, Mean age, General Medicine, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Middle Aged, Apex (geometry), Echocardiography, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, business, Large group, Cardiology and Cardiovascular Medicine, Human
Abstract

Aims To obtain the normal range for 2D echocardiographic (2DE) measurements of left ventricular (LV) layer-specific strain from a large group of healthy volunteers of both genders over a wide range of ages. Methods and results A total of 287 (109 men, mean age: 46 ± 14 years) healthy subjects were enrolled at 22 collaborating institutions of the EACVI Normal Reference Ranges for Echocardiography (NORRE) study. Layer-specific strain was analysed from the apical two-, three-, and four-chamber views using 2DE software. The lowest values of layer-specific strain calculated as ±1.96 standard deviations from the mean were −15.0% in men and −15.6% in women for epicardial strain, −16.8% and −17.7% for mid-myocardial strain, and −18.7% and −19.9% for endocardial strain, respectively. Basal-epicardial and mid-myocardial strain decreased with age in women (epicardial; P = 0.008, mid-myocardial; P = 0.003) and correlated with age (epicardial; r = −0.20, P = 0.007, mid-myocardial; r = −0.21, P = 0.006, endocardial; r = −0.23, P = 0.002), whereas apical-epicardial, mid-myocardial strain increased with the age in women (epicardial; P = 0.006, mid-myocardial; P = 0.03) and correlated with age (epicardial; r = 0.16, P = 0.04). End/Epi ratio at the apex was higher than at the middle and basal levels of LV in men (apex; 1.6 ± 0.2, middle; 1.2 ± 0.1, base 1.1 ± 0.1) and women (apex; 1.6 ± 0.1, middle; 1.1 ± 0.1, base 1.2 ± 0.1). Conclusion The NORRE study provides useful 2DE reference ranges for novel indices of layer-specific strain.

Published
2020

106. Echocardiographic reference ranges for normal left atrial function parameters results from the EACVI NORRE study

Author

Tadafumi, Sugimoto, Sébastien, Robinet, Raluca, Dulgheru, Anne, Bernard, Federica, Ilardi, Laura, Contu, Karima, Addetia, Luis, Caballero, George, Kacharava, George D, Athanassopoulos, Daniele, Barone, Monica, Baroni, Nuno, Cardim, Andreas, Hagendorff, Krasimira, Hristova, Teresa, Lopez, Gonzalo, de la Morena, Bogdan A, Popescu, Martin, Penicka, Tolga, Ozyigit, Jose David, Rodrigo Carbonero, Nico, van de Veire, Ralph Stephan, Von Bardeleben, Dragos, Vinereanu, Jose Luis, Zamorano, Yun Yun, Go, Stella, Marchetta, Alain, Nchimi, Monica, Rosca, Andreea, Calin, Marie, Moonen, Sara, Cimino, Julien, Magne, Bernard, Cosyns, Elena, Galli, Erwan, Donal, Gilbert, Habib, Roberta, Esposito, Maurizio, Galderisi, Luigi P, Badano, Roberto M, Lang, Patrizio, Lancellotti, Centre Hospitalier Universitaire de Liège (CHU-Liège), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hospital Univeristario Virgen de la Arrixaca, Onassis Cardiac Surgery Center [Athens] (OCSC), Universität Leipzig [Leipzig], Universidad de Alcalá - University of Alcalá (UAH), Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Timone [CHU - APHM] (TIMONE), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Hospital Clínico Universitario Virgen de la Arrixaca = University Hospital Virgen de la Arrixaca [Murcia], Universität Leipzig, CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinical sciences, Cardio-vascular diseases, Cardiology, Sugimoto, T, Robinet, S, Dulgheru, R, Bernard, A, Ilardi, F, Contu, L, Addetia, K, Caballero, L, Kacharava, G, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, Lopez, T, De La Morena, G, Popescu, B, Penicka, M, Ozyigit, T, Rodrigo Carbonero, J, Van De Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Go, Y, Marchetta, S, Nchimi, A, Rosca, M, Calin, A, Moonen, M, Cimino, S, Magne, J, Cosyns, B, Galli, E, Donal, E, Habib, G, Esposito, R, Galderisi, M, Badano, L, Lang, R, Lancellotti, P, Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), Sugimoto, Tadafumi, Robinet, Sébastien, Dulgheru, Raluca, Bernard, Anne, Ilardi, Federica, Contu, Laura, Addetia, Karima, Caballero, Lui, Kacharava, George, Athanassopoulos, George D, Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andrea, Hristova, Krasimira, Lopez, 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, Drago, Zamorano, Jose Lui, Go, Yun Yun, Marchetta, Stella, Nchimi, Alain, Rosca, Monica, Calin, Andreea, Moonen, Marie, Cimino, Sara, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Habib, Gilbert, Esposito, Roberta, Galderisi, Maurizio, Badano, Luigi P, Lang, Roberto M, and Lancellotti, Patrizio

Subjects
Male, deformation imaging, Pump function, Echocardiography, Three-Dimensional, Sex Factor, 030204 cardiovascular system & hematology, Cohort Studies, 0302 clinical medicine, Left atrial, Reference Values, Healthy volunteers, Image Processing, Computer-Assisted, Age Factor, adult echocardiography, left atrial function, reference values, 030212 general & internal medicine, Multivariate Analysi, Observer Variation, Healthy subjects, Age Factors, General Medicine, Middle Aged, Reference Standards, Healthy Volunteer, Healthy Volunteers, Homogeneous, Radiology Nuclear Medicine and imaging, Echocardiography, Cardiology, Linear Model, Atrial Function, Left, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, Human, Adult, medicine.medical_specialty, Statistics, Nonparametric, 03 medical and health sciences, Sex Factors, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Heart Atria, Left atrial function, business.industry, reference value, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Reference values, Multivariate Analysis, Linear Models, Reference Standard, Parameter, Cohort Studie, Large group, business
Abstract

International audience; Aims - To obtain the normal ranges for echocardiographic measurements of left atrial (LA) function from a large group of healthy volunteers accounting for age and gender. Methods and results - A total of 371 (median age 45 years) healthy subjects were enrolled at 22 collaborating institutions collaborating in the Normal Reference Ranges for Echocardiography (NORRE) study of the European Association of Cardiovascular Imaging (EACVI). Left atrial data sets were analysed with a vendor-independent software (VIS) package allowing homogeneous measurements irrespective of the echocardiographic equipment used to acquire data sets. The lowest expected values of LA function were 26.1%, 48.7%, and 41.4% for left atrial strain (LAS), 2D left atrial emptying fraction (LAEF), and 3D LAEF (reservoir function); 7.7%, 24.2%, and -0.53/s for LAS-active, LAEF-active, and LA strain rate during LA contraction (SRa) (pump function) and 12.0% and 21.6% for LAS-passive and LAEF-passive (conduit function). Left atrial reservoir and conduit function were decreased with age while pump function was increased. All indices of reservoir function and all LA strains had no difference in both gender and vendor. However, inter-vendor differences were observed in LA SRa despite the use of VIS. Conclusion - The NORRE study provides contemporary, applicable echocardiographic reference ranges for LA function. Our data highlight the importance of age-specific reference values for LA functions.

Published
2018

107. Echocardiographic reference ranges for normal left ventricular 2D strain: results from the EACVI NORRE study

Author

Ralph Stephan von Bardeleben, José Luis Zamorano, Jose David Rodrigo Carbonero, Maurizio Galderisi, Daniele Barone, Monica Baroni, Erwan Donal, Gonzalo de la Morena, Krasimira Hristova, Federica Ilardi, Tolga Ozyigit, Laura Contu, Anne Bernard, Natela Akhaladze, Martin Penicka, Yun Yun Go, Nico Van de Veire, Karima Addetia, Stella Marchetta, Bernard Cosyns, Nuno Cardim, Luis Caballero, Julien Magne, Roberto M. Lang, Dragos Vinereanu, Raluca Elena Dulgheru, Luigi P. Badano, Patrizio Lancellotti, Andreas Hagendorff, Andrea Calin, Tadafumi Sugimoto, Monica Rosca, Gilbert Habib, George Athanassopoulos, Bogdan A. Popescu, Marie Moonen, Teresa López, Cardio-vascular diseases, Clinical sciences, Faculty of Medicine and Pharmacy, Centre Hospitalier Universitaire de Liège (CHU-Liège), Universität Leipzig [Leipzig], Johannes Gutenberg - Universität Mainz (JGU), Universidad de Alcalá - University of Alcalá (UAH), CHU Dupuytren, Academisch Ziekenhuis Vrije Universiteit Brussel, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Universita degli Studi di Padova, University of Chicago, GE Healthcare, Philips Healthcare, Universität Leipzig, Johannes Gutenberg - Universität Mainz = Johannes Gutenberg University (JGU), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Università degli Studi di Padova = University of Padua (Unipd), Sugimoto, T, Dulgheru, R, Bernard, A, Ilardi, F, Contu, L, Addetia, K, Caballero, L, Akhaladze, N, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, Lopez, T, De La Morena, G, Popescu, B, Moonen, M, Penicka, M, Ozyigit, T, Carbonero, J, Van De Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Go, Y, Rosca, M, Calin, A, Magne, J, Cosyns, B, Marchetta, S, Donal, E, Habib, G, Galderisi, M, Badano, L, Lang, R, Lancellotti, P, Sugimoto, Tadafumi, Dulgheru, Raluca, Bernard, Anne, Ilardi, Federica, Contu, Laura, Addetia, Karima, Caballero, Lui, Akhaladze, Natela, Athanassopoulos, George D., Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andrea, Hristova, Krasimira, Lopez, Teresa, De La Morena, Gonzalo, Popescu, Bogdan A., Moonen, Marie, Penicka, Martin, Ozyigit, Tolga, Carbonero, Jose David Rodrigo, Van De Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Drago, Zamorano, Jose Lui, Go, Yun Yun, Rosca, Monica, Calin, Andrea, Magne, Julien, Cosyns, Bernard, Marchetta, Stella, Donal, Erwan, Habib, Gilbert, Galderisi, Maurizio, Badano, Luigi P., Lang, Roberto M., and Lancellotti, Patrizio

Subjects
Male, Longitudinal strain, deformation imaging, [SDV]Life Sciences [q-bio], Sex Factor, 030204 cardiovascular system & hematology, Standard deviation, Ventricular Function, Left, Heart Ventricle, 2D echocardiography, 0302 clinical medicine, Reference Values, Nuclear Medicine and Imaging, Image Processing, Computer-Assisted, Medicine, Circumferential strain, Age Factor, Reference Value, 030212 general & internal medicine, Multivariate Analysi, Adult echocardiography, Deformation imaging, Reference values, Radiology, Nuclear Medicine and Imaging, Cardiology and Cardiovascular Medicine, Observer Variation, Strain (chemistry), Age Factors, General Medicine, Middle Aged, Healthy Volunteer, Healthy Volunteers, Europe, Homogeneous, Echocardiography, Radiology Nuclear Medicine and imaging, Cardiology, Linear Model, Female, Radiology, Radial stress, Human, Adult, medicine.medical_specialty, adult echocardiography, Heart Ventricles, 03 medical and health sciences, Sex Factors, Internal medicine, Humans, Radiology, Nuclear Medicine and imaging, 2d strain, business.industry, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Multivariate Analysis, Linear Models, business
Abstract

International audience; Aims - To obtain the normal ranges for 2D echocardiographic (2DE) measurements of left ventricular (LV) strain from a large group of healthy volunteers accounting for age and gender. Methods and results - A total of 549 (mean age: 45.6 ± 13.3 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. 2DE data sets have been analysed with a vendor-independent software package allowing homogeneous measurements irrespective of the echocardiographic equipment used to acquire the data sets. The lowest expected values of LV strains and twist calculated as ± 1.96 standard deviations from the mean were -16.7% in men and -17.8% in women for longitudinal strain, -22.3% and -23.6% for circumferential strain, 20.6% and 21.5% for radial strain, and 2.2 degrees and 1.9 degrees for twist, respectively. In multivariable analysis, longitudinal strain decreased with age whereas the opposite occurred with circumferential and radial strain. Male gender was associated with lower strain for longitudinal, circumferential, and radial strain. Inter-vendor differences were observed for circumferential and radial strain despite the use of vendor-independent software. Importantly, no intervendor differences were noted in longitudinal strain. Conclusion - The NORRE study provides contemporary, applicable 2D echocardiographic reference ranges for LV longitudinal, radial, and circumferential strain. Our data highlight the importance of age- and gender-specific reference values for LV strain.

Published
2017

108. Normal Reference Ranges for Echocardiography: Rationale, study design, and methodology (NORRE Study)

Author

Gerald Maurer, Jose David Rodrigo Carbonero, Andreas Hagendorff, Geneviève Derumeaux, Natela Akhaladze, Martin Penicka, Ralph Stephan von Bardeleben, Seisyou Kou, Krasimira Hristova, Roberto M. Lang, Julien Magne, Nuno Cardim, Teresa López, Dragos Vinereanu, Bogdan A. Popescu, Damien Voilliot, Tolga Rasit, Gilbert Habib, Jens-Uwe Voigt, Maurizio Galderisi, Daniele Barone, Patrizio Lancellotti, Monica Baroni, Gonzalo de la Morena, Alexandra Gonçalves, Alessandro Salustri, Thor Edvardsen, J. Zamorano, Erwan Donal, Raluca Elena Dulgheru, Nico Van de Veire, George Athanassopoulos, Luigi P. Badano, José Juan Gómez de Diego, Lancellotti, Patrizio, Badano, Luigi P., Lang, Roberto M., Akhaladze, Natela, Athanassopoulos, George D., Barone, Daniele, Baroni, Monica, Cardim, Nuno, Gomez De Diego, Jose Juan, Derumeaux, Genevieve, Dulgheru, Raluca, Edvardsen, Thor, Galderisi, Maurizio, Gonçalves, Alexandra, Habib, Gilbert, Hagendorff, Andrea, Hristova, Krasimira, Kou, Seisyou, Lopez, Teresa, Magne, Julien, De La Morena, Gonzalo, Popescu, Bogdan A., Penicka, Martin, Rasit, Tolga, Rodrigo Carbonero, Jose David, Salustri, Alessandro, Van De Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Drago, Voigt, Jens Uwe, Voilliot, Damien, Zamorano, Jose Loui, Donal, Erwan, Maurer, Gerald, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA-Research), Université de Liège, Cardiac Imaging Center, Rush University Medical Center [Chicago], Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Cardiology, University and Emergency Hospital, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de cardiologie, Université médicale de Vienne, Autriche, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, Radiology, Nuclear Medicine and Imaging, MESH: Echocardiography, Doppler, Left, Sex Factor, 030204 cardiovascular system & hematology, Doppler echocardiography, Doppler imaging, MESH: Stroke Volume, MESH: Ventricular Function, Left, Ventricular Function, Left, 030218 nuclear medicine & medical imaging, Heart Ventricle, Cohort Studies, 0302 clinical medicine, [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing, Nuclear Medicine and Imaging, Ventricular Function, Age Factor, Prospective Studies, Prospective cohort study, MESH: Cohort Studies, MESH: Aged, 2D and 3D echocardiography, MESH: Middle Aged, medicine.diagnostic_test, Anthropometry, Age Factors, Doppler, General Medicine, Pulsed, Reference Standards, reference values, Middle Aged, Cardiac mechanic, Echocardiography, Doppler, 3. Good health, Europe, MESH: Echocardiography, Doppler, Pulsed, Cardiac mechanics, Echocardiography, MESH: Reference Standards, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, Radiology, Cardiology and Cardiovascular Medicine, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, Cohort study, Chamber size and function, M-mode, Adult, Aged, Echocardiography, Doppler, Pulsed, Heart Ventricles, Humans, Sensitivity and Specificity, Sex Factors, Stroke Volume, Human, medicine.medical_specialty, 03 medical and health sciences, MESH: Sex Factors, MESH: Anthropometry, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine, Medical physics, MESH: Age Factors, Reproducibility, MESH: Humans, business.industry, reference value, MESH: Adult, MESH: Male, MESH: Prospective Studies, MESH: Sensitivity and Specificity, Surgery, Clinical trial, Prospective Studie, Sample size determination, Reference Standard, Observational study, MESH: Europe, MESH: Heart Ventricles, Cohort Studie, business, MESH: Female
Abstract

International audience; BACKGROUND: Availability of normative reference values for cardiac chamber dimensions, volumes, mass, and function is a prerequisite for the accurate application of echocardiography for both clinical and research purposes. However, due to the lack of consistency in current echocardiographic 'reference values', their use for clinical decision-making remains questionable. AIMS: The aim of the 'Normal Reference Ranges for Echocardiography Study (NORRE Study)' is to obtain a set of 'normal values' for cardiac chamber geometry and function in a large cohort of healthy Caucasian individuals aged over a wide range of ages (25-75 years) using both conventional and advanced echocardiographic techniques. METHODS: The NORRE Study is a large prospective, observational multicentre study in which transthoracic echocardiographic studies will be acquired in 22 laboratories accredited by the European Association of Cardiovascular Imaging and in one laboratory in the USA accredited by ICAEL. The final sample size has been estimated in 1100 normal subjects in whom M-mode, 2D, and 3D imaging, colour Doppler, pulsed-wave Doppler, pulsed-wave tissue Doppler, and colour tissue Doppler imaging data will be obtained. All studies will be sent to a central echocardiographic core laboratory for quantitative analysis. Multiple studies will be performed for reproducibility analysis. CONCLUSION: After completion of the NORRE Study, uniform reference limits according to age, gender, and anthropometric parameters will be available to standardize the quantitative interpretation of echocardiography.

Published
2013

109. Women in cardiovascular imaging: a call for action to address ongoing challenges.

Author

Joshi SS, Kadavath S, Mandoli GE, Gimelli A, Gulati M, Thamman R, Lundberg G, Mehran R, Mulvagh SL, Sade LE, Shivalkar B, Shaw LJ, Hristova K, Dweck MR, Almeida AG, and Grapsa J

Subjects
Child, Humans, Female, Pregnancy, Prospective Studies, Surveys and Questionnaires, Sexual Harassment
Abstract

Aims: The EACVI Scientific Initiatives Committee and the EACVI women's taskforce conducted a global survey to evaluate the barriers faced by women in cardiovascular imaging (WICVi)., Methods and Results: In a prospective international survey, we assessed the barriers faced at work by WICVi. Three hundred fourteen participants from 53 countries responded. The majority were married (77%) and had children (68%), but most reported no flexibility in their work schedule during their pregnancy or after their maternity leave. More than half of the women reported experiencing unconscious bias (68%), verbal harassment (59%), conscious bias (51%), anxiety (70%), lack of motivation (60%), imposter syndrome (54%), and burnout (61%) at work. Furthermore, one in five respondents had experienced sexual harassment, although this was rarely reported formally. The majority reported availability of mentorship (73%), which was mostly rated as 'good' or 'very good'. While more than two-thirds of respondents (69%) now reported being well trained and qualified to take on leadership roles in their departments, only one-third had been afforded that opportunity. Despite the issues highlighted by this survey, >80% of the participating WICVi would still choose cardiovascular imaging if they could restart their career., Conclusion: The survey has highlighted important issues faced by WICVi. While progress has been made in areas such as mentorship and training, other issues including bullying, bias, and sexual harassment are still widely prevalent requiring urgent action by the global cardiovascular imaging community to collectively address and resolve these challenges., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2023
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110. Echocardiographic reference ranges for normal left ventricular layer-specific strain: results from the EACVI NORRE study.

Author

Tsugu T, Postolache A, Dulgheru R, Sugimoto T, Tridetti J, Nguyen Trung ML, Piette C, Moonen M, Manganaro R, Ilardi F, Chitroceanu AM, Sperlongano S, Go YY, Kacharava G, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Hagendorff A, Hristova K, Lopez T, de la Morena G, Popescu BA, Penicka M, Ozyigit T, Rodrigo Carbonero JD, van de Veire N, Von Bardeleben RS, Vinereanu D, Zamorano JL, Rosca M, Calin A, Magne J, Cosyns B, Galli E, Donal E, Santoro C, Galderisi M, Badano LP, Lang RM, and Lancellotti P

Subjects
Adult, Endocardium, Female, Humans, Male, Middle Aged, Myocardium, Reference Values, Ventricular Function, Left, Echocardiography, Heart Ventricles diagnostic imaging
Abstract

Aims: To obtain the normal range for 2D echocardiographic (2DE) measurements of left ventricular (LV) layer-specific strain from a large group of healthy volunteers of both genders over a wide range of ages., Methods and Results: A total of 287 (109 men, mean age: 46 ± 14 years) healthy subjects were enrolled at 22 collaborating institutions of the EACVI Normal Reference Ranges for Echocardiography (NORRE) study. Layer-specific strain was analysed from the apical two-, three-, and four-chamber views using 2DE software. The lowest values of layer-specific strain calculated as ±1.96 standard deviations from the mean were -15.0% in men and -15.6% in women for epicardial strain, -16.8% and -17.7% for mid-myocardial strain, and -18.7% and -19.9% for endocardial strain, respectively. Basal-epicardial and mid-myocardial strain decreased with age in women (epicardial; P = 0.008, mid-myocardial; P = 0.003) and correlated with age (epicardial; r = -0.20, P = 0.007, mid-myocardial; r = -0.21, P = 0.006, endocardial; r = -0.23, P = 0.002), whereas apical-epicardial, mid-myocardial strain increased with the age in women (epicardial; P = 0.006, mid-myocardial; P = 0.03) and correlated with age (epicardial; r = 0.16, P = 0.04). End/Epi ratio at the apex was higher than at the middle and basal levels of LV in men (apex; 1.6 ± 0.2, middle; 1.2 ± 0.1, base 1.1 ± 0.1) and women (apex; 1.6 ± 0.1, middle; 1.1 ± 0.1, base 1.2 ± 0.1)., Conclusion: The NORRE study provides useful 2DE reference ranges for novel indices of layer-specific strain., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)

Published
2020
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111. Correlation between non-invasive myocardial work indices and main parameters of systolic and diastolic function: results from the EACVI NORRE study.

Author

Manganaro R, Marchetta S, Dulgheru R, Sugimoto T, Tsugu T, Ilardi F, Cicenia M, Ancion A, Postolache A, Martinez C, Kacharava G, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Hagendorff A, Hristova K, Lopez T, de la Morena G, Popescu BA, Penicka M, Ozyigit T, Rodrigo Carbonero JD, van de Veire N, Von Bardeleben RS, Vinereanu D, Zamorano JL, Rosca M, Calin A, Moonen M, Magne J, Cosyns B, Galli E, Donal E, Carerj S, Zito C, Santoro C, Galderisi M, Badano LP, Lang RM, and Lancellotti P

Subjects
Adult, Diastole, Echocardiography, Humans, Male, Middle Aged, Stroke Volume, Systole, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Function, Left
Abstract

Aims: The present study sought to evaluate the correlation between indices of non-invasive myocardial work (MW) and left ventricle (LV) size, traditional and advanced parameters of LV systolic and diastolic function by 2D echocardiography (2DE)., 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 LV pressure-strain loops using custom software. Peak LV pressure was estimated non-invasively from brachial artery cuff pressure. LV size, parameters of systolic and diastolic function and ventricular-arterial coupling were measured by echocardiography. As advanced indices of myocardial performance, global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained. On multivariable analysis, GWI was significantly correlated with GLS (standardized beta-coefficient = -0.23, P < 0.001), ejection fraction (EF) (standardized beta-coefficient = 0.15, P = 0.02), systolic blood pressure (SBP) (standardized beta-coefficient = 0.56, P < 0.001) and GRS (standardized beta-coefficient = 0.19, P = 0.004), while GCW was correlated with GLS (standardized beta-coefficient = -0.55, P < 0.001), SBP (standardized beta-coefficient = 0.71, P < 0.001), GRS (standardized beta-coefficient = 0.11, P = 0.02), and GCS (standardized beta-coefficient = -0.10, P = 0.01). GWE was directly correlated with EF and inversely correlated with Tei index (standardized beta-coefficient = 0.18, P = 0.009 and standardized beta-coefficient = -0.20, P = 0.004, respectively), the opposite occurred for GWW (standardized beta-coefficient =--0.14, P = 0.03 and standardized beta-coefficient = 0.17, P = 0.01, respectively)., Conclusion: The non-invasive MW indices show a good correlation with traditional 2DE parameters of myocardial systolic function and myocardial strain., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.)

Published
2020
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112. Echocardiographic reference ranges for normal non-invasive myocardial work indices: results from the EACVI NORRE study.

Author

Manganaro R, Marchetta S, Dulgheru R, Ilardi F, Sugimoto T, Robinet S, Cimino S, Go YY, Bernard A, Kacharava G, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Hagendorff A, Hristova K, López-Fernández T, de la Morena G, Popescu BA, Penicka M, Ozyigit T, Rodrigo Carbonero JD, van de Veire N, Von Bardeleben RS, Vinereanu D, Zamorano JL, Rosca M, Calin A, Moonen M, Magne J, Cosyns B, Galli E, Donal E, Carerj S, Zito C, Santoro C, Galderisi M, Badano LP, Lang RM, Oury C, and Lancellotti P

Subjects
Europe, Female, Humans, Male, Middle Aged, Prospective Studies, Reference Values, Echocardiography methods, Heart Function Tests
Abstract

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., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.)

Published
2019
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113. Echocardiographic reference ranges for normal left atrial function parameters: results from the EACVI NORRE study.

Author

Sugimoto T, Robinet S, Dulgheru R, Bernard A, Ilardi F, Contu L, Addetia K, Caballero L, Kacharava G, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Hagendorff A, Hristova K, Lopez T, de la Morena G, Popescu BA, Penicka M, Ozyigit T, Rodrigo Carbonero JD, van de Veire N, Von Bardeleben RS, Vinereanu D, Zamorano JL, Go YY, Marchetta S, Nchimi A, Rosca M, Calin A, Moonen M, Cimino S, Magne J, Cosyns B, Galli E, Donal E, Habib G, Esposito R, Galderisi M, Badano LP, Lang RM, and Lancellotti P

Subjects
Adult, Age Factors, Cohort Studies, Echocardiography, Three-Dimensional methods, Female, Healthy Volunteers, Humans, Linear Models, Male, Middle Aged, Multivariate Analysis, Observer Variation, Reference Standards, Sex Factors, Statistics, Nonparametric, Atrial Function, Left physiology, Echocardiography methods, Heart Atria diagnostic imaging, Image Processing, Computer-Assisted methods
Abstract

Aims: To obtain the normal ranges for echocardiographic measurements of left atrial (LA) function from a large group of healthy volunteers accounting for age and gender., Methods and Results: A total of 371 (median age 45 years) healthy subjects were enrolled at 22 collaborating institutions collaborating in the Normal Reference Ranges for Echocardiography (NORRE) study of the European Association of Cardiovascular Imaging (EACVI). Left atrial data sets were analysed with a vendor-independent software (VIS) package allowing homogeneous measurements irrespective of the echocardiographic equipment used to acquire data sets. The lowest expected values of LA function were 26.1%, 48.7%, and 41.4% for left atrial strain (LAS), 2D left atrial emptying fraction (LAEF), and 3D LAEF (reservoir function); 7.7%, 24.2%, and -0.53/s for LAS-active, LAEF-active, and LA strain rate during LA contraction (SRa) (pump function) and 12.0% and 21.6% for LAS-passive and LAEF-passive (conduit function). Left atrial reservoir and conduit function were decreased with age while pump function was increased. All indices of reservoir function and all LA strains had no difference in both gender and vendor. However, inter-vendor differences were observed in LA SRa despite the use of VIS., Conclusion: The NORRE study provides contemporary, applicable echocardiographic reference ranges for LA function. Our data highlight the importance of age-specific reference values for LA functions.

Published
2018
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114. Echocardiographic reference ranges for normal left ventricular 2D strain: results from the EACVI NORRE study.

Author

Sugimoto T, Dulgheru R, Bernard A, Ilardi F, Contu L, Addetia K, Caballero L, Akhaladze N, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Hagendorff A, Hristova K, Lopez T, de la Morena G, Popescu BA, Moonen M, Penicka M, Ozyigit T, Rodrigo Carbonero JD, van de Veire N, von Bardeleben RS, Vinereanu D, Zamorano JL, Go YY, Rosca M, Calin A, Magne J, Cosyns B, Marchetta S, Donal E, Habib G, Galderisi M, Badano LP, Lang RM, and Lancellotti P

Subjects
Adult, Age Factors, Europe, Female, Healthy Volunteers, Humans, Linear Models, Male, Middle Aged, Multivariate Analysis, Observer Variation, Reference Values, Sex Factors, Echocardiography methods, Heart Ventricles diagnostic imaging, Image Processing, Computer-Assisted, Ventricular Function, Left physiology
Abstract

Aims: To obtain the normal ranges for 2D echocardiographic (2DE) measurements of left ventricular (LV) strain from a large group of healthy volunteers accounting for age and gender., Methods and Results: A total of 549 (mean age: 45.6 ± 13.3 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. 2DE data sets have been analysed with a vendor-independent software package allowing homogeneous measurements irrespective of the echocardiographic equipment used to acquire the data sets. The lowest expected values of LV strains and twist calculated as ± 1.96 standard deviations from the mean were -16.7% in men and -17.8% in women for longitudinal strain, -22.3% and -23.6% for circumferential strain, 20.6% and 21.5% for radial strain, and 2.2 degrees and 1.9 degrees for twist, respectively. In multivariable analysis, longitudinal strain decreased with age whereas the opposite occurred with circumferential and radial strain. Male gender was associated with lower strain for longitudinal, circumferential, and radial strain. Inter-vendor differences were observed for circumferential and radial strain despite the use of vendor-independent software. Importantly, no intervendor differences were noted in longitudinal strain., Conclusion: The NORRE study provides contemporary, applicable 2D echocardiographic reference ranges for LV longitudinal, radial, and circumferential strain. Our data highlight the importance of age- and gender-specific reference values for LV strain., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.)

Published
2017
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115. 3D echocardiographic reference ranges for normal left ventricular volumes and strain: results from the EACVI NORRE study.

Author

Bernard A, Addetia K, Dulgheru R, Caballero L, Sugimoto T, Akhaladze N, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Hagendorff A, Hristova K, Ilardi F, Lopez T, de la Morena G, Popescu BA, Penicka M, Ozyigit T, David Rodrigo Carbonero J, van de Veire N, Stephan Von Bardeleben R, Vinereanu D, Luis Zamorano J, Martinez C, Magne J, Cosyns B, Donal E, Habib G, Badano LP, Lang RM, and Lancellotti P

Subjects
Adult, Aged, Female, Healthy Volunteers, Humans, Male, Middle Aged, Reference Values, Young Adult, Cardiac Volume physiology, Echocardiography, Three-Dimensional, Heart Ventricles diagnostic imaging, Ventricular Function, Left physiology
Abstract

Aim: To obtain the normal ranges for 3D echocardiography (3DE) measurement of left ventricular (LV) volumes, function, and strain from a large group of healthy volunteers., Methods and Results: A total of 440 (mean age: 45 ± 13 years) out of the 734 healthy subjects enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study had good-quality 3DE data sets that have been analysed with a vendor-independent software package allowing homogeneous measurements regardless of the echocardiographic machine used to acquire the data sets. Upper limits of LV end-diastolic and end-systolic volumes were larger in men (97 and 42 mL/m2) than in women (82 and 35 mL/m2; P < 0.0001). Conversely, lower limits of LV ejection fraction were higher in women than in men (51% vs. 50%; P < 0.01). Similarly, all strain components were higher in women than in men. Lower range was -18.6% in men and -19.5% in women for 3D longitudinal strain, -27.0% and -27.6% for 3D circumferential strain, -33.2% and -34.4% for 3D tangential strain and 38.8% and 40.7% for 3D radial strain, respectively. LV volumes decreased with age in both genders (P < 0.0001), whereas LV ejection fraction increased with age only in men. Among 3DE LV strain components, the only one, which did not change with age was longitudinal strain., Conclusion: The NORRE study provides applicable 3D echocardiographic reference ranges for LV function assessment. Our data highlight the importance of age- and gender-specific reference values for both LV volumes and strain., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions, please email: journals.permissions@oup.com.)

Published
2017
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116. Two-dimensional transthoracic echocardiographic normal reference ranges for proximal aorta dimensions: results from the EACVI NORRE study.

Author

Saura D, Dulgheru R, Caballero L, Bernard A, Kou S, Gonjilashvili N, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Hagendorff A, Hristova K, Lopez T, de la Morena G, Popescu BA, Penicka M, Ozyigit T, Rodrigo Carbonero JD, Van De Veire N, Von Bardeleben RS, Vinereanu D, Zamorano JL, Gori AS, Cosyns B, Donal E, Habib G, Addetia K, Lang RM, Badano LP, and Lancellotti P

Subjects
Adult, Age Factors, Analysis of Variance, Cohort Studies, Europe, Female, Healthy Volunteers, Humans, Linear Models, Male, Middle Aged, Multivariate Analysis, Prospective Studies, Reference Values, Sex Factors, Systole physiology, Young Adult, Aorta, Thoracic anatomy & histology, Aorta, Thoracic diagnostic imaging, Diastole physiology, Echocardiography
Abstract

Aims: To report normal reference ranges for echocardiographic dimensions of the proximal aorta obtained in a large group of healthy volunteers recruited using state-of-the-art cardiac ultrasound equipment, considering different measurement conventions, and taking into account gender, age, and body size of individuals., Methods and Results: A total of 704 (mean age: 46.0 ± 13.5 years) healthy volunteers (310 men and 394 women) were prospectively recruited from the collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. A comprehensive echocardiographic examination was obtained in all subjects following pre-defined protocols. Aortic dimensions were obtained in systole and diastole, following both the leading-edge to leading-edge and the inner-edge to inner-edge conventions. Diameters were measured at four levels: ventricular-arterial junction, sinuses of Valsalva, sino-tubular junction, and proximal tubular ascending aorta. Measures of aortic root in the short-axis view following the orientation of each of the three sinuses were also performed. Men had significantly larger body sizes when compared with women, and showed larger aortic dimensions independently of the measurement method used. Dimensions indexed by height and body surface area are provided, and stratification by age ranges is also displayed. In multivariable analysis, the independent predictors of aortic dimensions were age, gender, and height or body surface area., Conclusion: The NORRE study provides normal values of proximal aorta dimensions as assessed by echocardiography. Reference ranges for different anatomical levels using different (i) measurement conventions and (ii) at different times of the cardiac cycle (i.e. mid-systole and end-diastole) are provided. Age, gender, and body size were significant determinants of aortic dimensions., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.)

Published
2017
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117. Echocardiographic reference ranges for normal cardiac Doppler data: results from the NORRE Study.

Author

Caballero L, Kou S, Dulgheru R, Gonjilashvili N, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Gomez de Diego JJ, Oliva MJ, Hagendorff A, Hristova K, Lopez T, Magne J, Martinez C, de la Morena G, Popescu BA, Penicka M, Ozyigit T, Rodrigo Carbonero JD, Salustri A, Van De Veire N, Von Bardeleben RS, Vinereanu D, Voigt JU, Zamorano JL, Bernard A, Donal E, Lang RM, Badano LP, and Lancellotti P

Subjects
Adult, Age Factors, Aged, Cohort Studies, Diastole physiology, Europe, Female, Healthy Volunteers, Humans, Male, Middle Aged, Reference Values, Sex Factors, Systole physiology, Young Adult, Aging physiology, Echocardiography, Doppler methods, Heart Ventricles diagnostic imaging, Ventricular Function, Left physiology
Abstract

Aims: Reference values for Doppler parameters according to age and gender are recommended for the assessment of heart physiology, specifically for left ventricular (LV) diastolic function. In this study, we report normal reference ranges for Doppler parameters obtained in a large group of healthy volunteers. Echocardiographic data were acquired using state-of-the-art cardiac ultrasound equipment following Doppler acquisition and measurement protocols approved by the European Association of Cardiovascular Imaging., Methods and Results: A total of 449 (mean age: 45.8 ± 13.7 years) healthy volunteers (198 men and 251 women) were enrolled at the collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. A comprehensive echocardiographic examination was obtained from all subjects following predefined protocols. The majority of the Doppler diastolic parameters (e', E/e') as well as right ventricle systolic s' wave velocity were similar in men and women. Left ventricle s' wave velocity was higher in men than in women. E wave and e' were higher in younger subjects and decreased progressively in the older ones. E/e' ratio increased with ageing. Septal e' <8 cm/s was present in 19.7% of the subjects in the 40-60 year group and in 55% of those in the ≥60 year group. However, the cut-off value of average E/e' or lateral E/e' remained <15 or 13, respectively, in the majority of patients., Conclusion: The NORRE study provides the reference values for the most useful Doppler parameters in the evaluation of heart physiology. These data highlight the need of using age-specific reference values especially for the diagnosis of LV systolic and diastolic dysfunction and for the estimation of LV filling pressures., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.)

Published
2015
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118. Normal Reference Ranges for Echocardiography: rationale, study design, and methodology (NORRE Study).

Author

Lancellotti P, Badano LP, Lang RM, Akhaladze N, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Gomez de Diego JJ, Derumeaux G, Dulgheru R, Edvardsen T, Galderisi M, Gonçalves A, Habib G, Hagendorff A, Hristova K, Kou S, Lopez T, Magne J, de la Morena G, Popescu BA, Penicka M, Rasit T, Rodrigo Carbonero JD, Salustri A, Van de Veire N, von Bardeleben RS, Vinereanu D, Voigt JU, Voilliot D, Zamorano JL, Donal E, and Maurer G

Subjects
Adult, Age Factors, Aged, Anthropometry, Cohort Studies, Echocardiography, Doppler, Pulsed, Europe, Female, Heart Ventricles anatomy & histology, Humans, Male, Middle Aged, Prospective Studies, Reference Standards, Sensitivity and Specificity, Sex Factors, Stroke Volume physiology, Echocardiography, Doppler methods, Heart Ventricles diagnostic imaging, Ventricular Function, Left physiology
Abstract

Background: Availability of normative reference values for cardiac chamber dimensions, volumes, mass, and function is a prerequisite for the accurate application of echocardiography for both clinical and research purposes. However, due to the lack of consistency in current echocardiographic 'reference values', their use for clinical decision-making remains questionable., Aims: The aim of the 'Normal Reference Ranges for Echocardiography Study (NORRE Study)' is to obtain a set of 'normal values' for cardiac chamber geometry and function in a large cohort of healthy Caucasian individuals aged over a wide range of ages (25-75 years) using both conventional and advanced echocardiographic techniques., Methods: The NORRE Study is a large prospective, observational multicentre study in which transthoracic echocardiographic studies will be acquired in 22 laboratories accredited by the European Association of Cardiovascular Imaging and in one laboratory in the USA accredited by ICAEL. The final sample size has been estimated in 1100 normal subjects in whom M-mode, 2D, and 3D imaging, colour Doppler, pulsed-wave Doppler, pulsed-wave tissue Doppler, and colour tissue Doppler imaging data will be obtained. All studies will be sent to a central echocardiographic core laboratory for quantitative analysis. Multiple studies will be performed for reproducibility analysis., Conclusion: After completion of the NORRE Study, uniform reference limits according to age, gender, and anthropometric parameters will be available to standardize the quantitative interpretation of echocardiography.

Published
2013
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