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1. Normal Values of Left Ventricular Size and Function on Three-Dimensional Echocardiography: Results of the World Alliance Societies of Echocardiography Study

Author

Addetia, K, Miyoshi, T, Amuthan, V, Citro, R, Daimon, M, Gutierrez Fajardo, P, Kasliwal, R, Kirkpatrick, J, Monaghan, M, Muraru, D, Ogunyankin, K, Park, S, Ronderos, R, Sadeghpour, A, Scalia, G, Takeuchi, M, Tsang, W, Tucay, E, Tude Rodrigues, A, Zhang, Y, Hitschrich, N, Blankenhagen, M, Degel, M, Schreckenberg, M, Mor-Avi, V, Asch, F, Lang, R, Prado, A, Filipini, E, Kwon, A, Hoschke-Edwards, S, Afonso, T, Thampinathan, B, Sooriyakanthan, M, Zhu, T, Wang, Z, Wang, Y, Yin, L, Li, S, Alagesan, R, Balasubramanian, S, Ananth, R, Bansal, M, Badano, L, Bossone, E, Di Vece, D, Bellino, M, Nakao, T, Kawata, T, Hirokawa, M, Sawada, N, Nabeshima, Y, Yun, H, Hwang, J, Addetia K., Miyoshi T., Amuthan V., Citro R., Daimon M., Gutierrez Fajardo P., Kasliwal R. R., Kirkpatrick J. N., Monaghan M. J., Muraru D., Ogunyankin K. O., Park S. W., Ronderos R. E., Sadeghpour A., Scalia G. M., Takeuchi M., Tsang W., Tucay E. S., Tude Rodrigues A. C., Zhang Y., Hitschrich N., Blankenhagen M., Degel M., Schreckenberg M., Mor-Avi V., Asch F. M., Lang R. M., Prado A. D., Filipini E., Kwon A., Hoschke-Edwards S., Afonso T. R., Thampinathan B., Sooriyakanthan M., Zhu T., Wang Z., Wang Y., Yin L., Li S., Alagesan R., Balasubramanian S., Ananth R. V. A., Bansal M., Badano L., Bossone E., Di Vece D., Bellino M., Nakao T., Kawata T., Hirokawa M., Sawada N., Nabeshima Y., Yun H. R., Hwang J. -W., Addetia, K, Miyoshi, T, Amuthan, V, Citro, R, Daimon, M, Gutierrez Fajardo, P, Kasliwal, R, Kirkpatrick, J, Monaghan, M, Muraru, D, Ogunyankin, K, Park, S, Ronderos, R, Sadeghpour, A, Scalia, G, Takeuchi, M, Tsang, W, Tucay, E, Tude Rodrigues, A, Zhang, Y, Hitschrich, N, Blankenhagen, M, Degel, M, Schreckenberg, M, Mor-Avi, V, Asch, F, Lang, R, Prado, A, Filipini, E, Kwon, A, Hoschke-Edwards, S, Afonso, T, Thampinathan, B, Sooriyakanthan, M, Zhu, T, Wang, Z, Wang, Y, Yin, L, Li, S, Alagesan, R, Balasubramanian, S, Ananth, R, Bansal, M, Badano, L, Bossone, E, Di Vece, D, Bellino, M, Nakao, T, Kawata, T, Hirokawa, M, Sawada, N, Nabeshima, Y, Yun, H, Hwang, J, Addetia K., Miyoshi T., Amuthan V., Citro R., Daimon M., Gutierrez Fajardo P., Kasliwal R. R., Kirkpatrick J. N., Monaghan M. J., Muraru D., Ogunyankin K. O., Park S. W., Ronderos R. E., Sadeghpour A., Scalia G. M., Takeuchi M., Tsang W., Tucay E. S., Tude Rodrigues A. C., Zhang Y., Hitschrich N., Blankenhagen M., Degel M., Schreckenberg M., Mor-Avi V., Asch F. M., Lang R. M., Prado A. D., Filipini E., Kwon A., Hoschke-Edwards S., Afonso T. R., Thampinathan B., Sooriyakanthan M., Zhu T., Wang Z., Wang Y., Yin L., Li S., Alagesan R., Balasubramanian S., Ananth R. V. A., Bansal M., Badano L., Bossone E., Di Vece D., Bellino M., Nakao T., Kawata T., Hirokawa M., Sawada N., Nabeshima Y., Yun H. R., and Hwang J. -W.

Abstract

Background: Echocardiography remains the most widely used modality to assess left ventricular (LV) chamber size and function. Currently this assessment is most frequently performed using two-dimensional (2D) echocardiography. However, three-dimensional (3D) echocardiography has been shown to be more accurate and reproducible than 2D echocardiography. Current normative reference values for 3D LV analysis are based predominantly on data from North America and Europe. The World Alliance Societies of Echocardiography study was designed to sample normal subjects from around the world to provide more universal global reference ranges. The aim of this study was to assess the worldwide feasibility of LV 3D echocardiography and report on size and functional measurements. Methods: A total of 2,262 healthy subjects were prospectively enrolled from 19 centers in 15 countries. Three-dimensional LV full-volume data sets were obtained and analyzed offline using vendor-neutral software. Measurements included LV end-diastolic and end-systolic volumes, LV ejection fraction (LVEF), global longitudinal strain (GLS), and global circumferential strain. Results were categorized by age (18-40, 41-65, and >65 years), sex, and race. Results: A total of 1,589 subjects (feasibility 70%) had adequate LV data sets for analysis. Mean normal values for indexed end-diastolic volume, end-systolic volume, and LVEF in men and women were 70 ± 15 and 65 ± 12 mL/m2, 28 ± 7 and 25 ± 6 mL/m2, and 60 ± 5% and 62 ± 5%, respectively. Men had larger LV volumes and lower LVEFs than women. GLS and global circumferential strain were higher in magnitude in women. In both sexes, LV volumes were lower and LVEF tended to be higher with increasing age, especially considering the differences between the youngest and oldest age groups. Although GLS was similar across age groups in men, in women, the youngest and middle-age cohorts revealed higher magnitudes of GLS compared with the oldest age group. Global circumfere

Published
2022

2. Normal Values of Cardiac Output and Stroke Volume According to Measurement Technique, Age, Sex, and Ethnicity: Results of the World Alliance of Societies of Echocardiography Study

Author

Patel, H, Miyoshi, T, Addetia, K, Henry, M, Citro, R, Daimon, M, Gutierrez Fajardo, P, Kasliwal, R, Kirkpatrick, J, Monaghan, M, Muraru, D, Ogunyankin, K, Park, S, Ronderos, R, Sadeghpour, A, Scalia, G, Takeuchi, M, Tsang, W, Tucay, E, Tude Rodrigues, A, Vivekanandan, A, Zhang, Y, Schreckenberg, M, Blankenhagen, M, Degel, M, Rossmanith, A, Mor-Avi, V, Asch, F, Lang, R, Prado, A, Filipini, E, Kwon, A, Hoschke-Edwards, S, Afonso, T, Thampinathan, B, Sooriyakanthan, M, Zhu, T, Wang, Z, Wang, Y, Yin, L, Li, S, Alagesan, R, Balasubramanian, S, Ananth, R, Bansal, M, Alizadehasl, A, Badano, L, Bossone, E, Di Vece, D, Bellino, M, Nakao, T, Kawata, T, Hirokawa, M, Sawada, N, Nabeshima, Y, Yun, H, Hwang, J, Patel H. N., Miyoshi T., Addetia K., Henry M. P., Citro R., Daimon M., Gutierrez Fajardo P., Kasliwal R. R., Kirkpatrick J. N., Monaghan M. J., Muraru D., Ogunyankin K. O., Park S. W., Ronderos R. E., Sadeghpour A., Scalia G. M., Takeuchi M., Tsang W., Tucay E. S., Tude Rodrigues A. C., Vivekanandan A., Zhang Y., Schreckenberg M., Blankenhagen M., Degel M., Rossmanith A., Mor-Avi V., Asch F. M., Lang R. M., Prado A. D., Filipini E., Kwon A., Hoschke-Edwards S., Afonso T. R., Thampinathan B., Sooriyakanthan M., Zhu T., Wang Z., Wang Y., Yin L., Li S., Alagesan R., Balasubramanian S., Ananth R. V. A., Bansal M., Alizadehasl A., Badano L., Bossone E., Di Vece D., Bellino M., Nakao T., Kawata T., Hirokawa M., Sawada N., Nabeshima Y., Yun H. R., Hwang J. -W., Patel, H, Miyoshi, T, Addetia, K, Henry, M, Citro, R, Daimon, M, Gutierrez Fajardo, P, Kasliwal, R, Kirkpatrick, J, Monaghan, M, Muraru, D, Ogunyankin, K, Park, S, Ronderos, R, Sadeghpour, A, Scalia, G, Takeuchi, M, Tsang, W, Tucay, E, Tude Rodrigues, A, Vivekanandan, A, Zhang, Y, Schreckenberg, M, Blankenhagen, M, Degel, M, Rossmanith, A, Mor-Avi, V, Asch, F, Lang, R, Prado, A, Filipini, E, Kwon, A, Hoschke-Edwards, S, Afonso, T, Thampinathan, B, Sooriyakanthan, M, Zhu, T, Wang, Z, Wang, Y, Yin, L, Li, S, Alagesan, R, Balasubramanian, S, Ananth, R, Bansal, M, Alizadehasl, A, Badano, L, Bossone, E, Di Vece, D, Bellino, M, Nakao, T, Kawata, T, Hirokawa, M, Sawada, N, Nabeshima, Y, Yun, H, Hwang, J, Patel H. N., Miyoshi T., Addetia K., Henry M. P., Citro R., Daimon M., Gutierrez Fajardo P., Kasliwal R. R., Kirkpatrick J. N., Monaghan M. J., Muraru D., Ogunyankin K. O., Park S. W., Ronderos R. E., Sadeghpour A., Scalia G. M., Takeuchi M., Tsang W., Tucay E. S., Tude Rodrigues A. C., Vivekanandan A., Zhang Y., Schreckenberg M., Blankenhagen M., Degel M., Rossmanith A., Mor-Avi V., Asch F. M., Lang R. M., Prado A. D., Filipini E., Kwon A., Hoschke-Edwards S., Afonso T. R., Thampinathan B., Sooriyakanthan M., Zhu T., Wang Z., Wang Y., Yin L., Li S., Alagesan R., Balasubramanian S., Ananth R. V. A., Bansal M., Alizadehasl A., Badano L., Bossone E., Di Vece D., Bellino M., Nakao T., Kawata T., Hirokawa M., Sawada N., Nabeshima Y., Yun H. R., and Hwang J. -W.

Abstract

Background: Assessment of cardiac output (CO) and stroke volume (SV) is essential to understand cardiac function and hemodynamics. These parameters can be examined using three echocardiographic techniques (pulsed-wave Doppler, two-dimensional [2D], and three-dimensional [3D]). Whether these methods can be used interchangeably is unclear. The influence of age, sex, and ethnicity on CO and SV has also not been examined in depth. In this report from the World Alliance of Societies of Echocardiography Normal Values Study, the authors compare CO and SV in healthy adults according to age, sex, ethnicity, and measurement techniques. Methods: A total of 1,450 adult subjects (53% men) free of heart, lung, and kidney disease were prospectively enrolled in 15 countries, with even distributions among age groups and sex. Subjects were divided into three age groups (young, 18–40 years; middle aged, 41–65 years; and old, >65 years) and three main racial groups (whites, blacks, and Asians). CO and SV were indexed (cardiac index [CI] and SV index [SVI], respectively) to body surface area and height and measured using three echocardiographic methods: Doppler, 2D, and 3D. Images were analyzed at two core laboratories (one each for 2D and 3D). Results: CI and SVI were significantly lower by 2D compared with both Doppler and 3D methods in both sexes. SVI was significantly lower in women than men by all three methods, while CI differed only by 2D. SVI decreased with aging by all three techniques, whereas CI declined only with 2D and 3D. CO and SV were smallest in Asians and largest in whites, and the differences persisted after normalization for body surface area. Conclusions: The present results provide normal reference values for CO and SV, which differ by age, sex, and race. Furthermore, CI and SVI measurements by the different echocardiographic techniques are not interchangeable. All these factors need to be taken into account when evaluating cardiac function and hemodynamics in i

Published
2021

3. Normal Values of Right Atrial Size and Function According to Age, Sex, and Ethnicity: Results of the World Alliance Societies of Echocardiography Study

Author

Soulat-Dufour, L, Addetia, K, Miyoshi, T, Citro, R, Daimon, M, Fajardo, P, Kasliwal, R, Kirkpatrick, J, Monaghan, M, Muraru, D, Ogunyankin, K, Park, S, Ronderos, R, Sadeghpour, A, Scalia, G, Takeuchi, M, Tsang, W, Tucay, E, Tude Rodrigues, A, Vivekanandan, A, Zhang, Y, Diehl, M, Schreckenberg, M, Mor-Avi, V, Asch, F, Lang, R, Prad, A, Kwon, A, Hoschke-Edwards, S, Afonso, T, Thampinathan, B, Sooriyakanthan, M, Zhu, T, Wang, Z, Alagesan, R, Alizadehasl, A, Badano, L, Nakao, T, Kawata, T, Hirokawa, M, Sawada, N, Yun, H, Hwang, J, Soulat-Dufour L., Addetia K., Miyoshi T., Citro R., Daimon M., Fajardo P. G., Kasliwal R. R., Kirkpatrick J. N., Monaghan M. J., Muraru D., Ogunyankin K. O., Park S. W., Ronderos R. E., Sadeghpour A., Scalia G. M., Takeuchi M., Tsang W., Tucay E. S., Tude Rodrigues A. C., Vivekanandan A., Zhang Y., Diehl M., Schreckenberg M., Mor-Avi V., Asch F. M., Lang R. M., Prad A. D., Kwon A., Hoschke-Edwards S., Afonso T. R., Thampinathan B., Sooriyakanthan M., Zhu T., Wang Z., Alagesan R., Alizadehasl A., Badano L., Nakao T., Kawata T., Hirokawa M., Sawada N., Yun H. R., Hwang J. -W., Soulat-Dufour, L, Addetia, K, Miyoshi, T, Citro, R, Daimon, M, Fajardo, P, Kasliwal, R, Kirkpatrick, J, Monaghan, M, Muraru, D, Ogunyankin, K, Park, S, Ronderos, R, Sadeghpour, A, Scalia, G, Takeuchi, M, Tsang, W, Tucay, E, Tude Rodrigues, A, Vivekanandan, A, Zhang, Y, Diehl, M, Schreckenberg, M, Mor-Avi, V, Asch, F, Lang, R, Prad, A, Kwon, A, Hoschke-Edwards, S, Afonso, T, Thampinathan, B, Sooriyakanthan, M, Zhu, T, Wang, Z, Alagesan, R, Alizadehasl, A, Badano, L, Nakao, T, Kawata, T, Hirokawa, M, Sawada, N, Yun, H, Hwang, J, Soulat-Dufour L., Addetia K., Miyoshi T., Citro R., Daimon M., Fajardo P. G., Kasliwal R. R., Kirkpatrick J. N., Monaghan M. J., Muraru D., Ogunyankin K. O., Park S. W., Ronderos R. E., Sadeghpour A., Scalia G. M., Takeuchi M., Tsang W., Tucay E. S., Tude Rodrigues A. C., Vivekanandan A., Zhang Y., Diehl M., Schreckenberg M., Mor-Avi V., Asch F. M., Lang R. M., Prad A. D., Kwon A., Hoschke-Edwards S., Afonso T. R., Thampinathan B., Sooriyakanthan M., Zhu T., Wang Z., Alagesan R., Alizadehasl A., Badano L., Nakao T., Kawata T., Hirokawa M., Sawada N., Yun H. R., and Hwang J. -W.

Abstract

Background: The World Alliance Societies of Echocardiography study is a multicenter, international, prospective, cross-sectional study whose aims were to evaluate healthy adult individuals to establish age- and sex-normative values of echocardiographic parameters and to determine whether differences exist among people from different countries and of different ethnicities. The present report focuses on two-dimensional (2D) and three-dimensional (3D) right atrial (RA) size and function. Methods: Transthoracic 2D and 3D echocardiographic images were obtained in 2,008 healthy adult individuals evenly distributed among subgroups according to sex (1,033 men, 975 women) and age 18 to 40 years (n = 854), 41 to 65 years (n = 653), and >65 years (n = 501). For ethnicity, 34.9% were white, 41.6% Asian, and 9.7% black. Images were analyzed in a core laboratory according to current American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines. RA measurements included 2D dimensions, 2D and 3D RA volumes (RAVs) indexed to body surface area (BSA), emptying fraction (EmF), and global longitudinal strain, including total/reservoir, passive/conduit, and active/contractile phases. Differences among age and sex categories and among countries were also examined. Results: RAVs were larger in men (even after BSA indexing), while 3D total EmF and global longitudinal strain magnitudes were higher in women. For both sexes, there were no significant age-related differences in 2D RAV measurements, but 3D RAV values differed minimally with age, remaining significant after BSA indexing. RA total EmF and reservoir strain and passive EmF and conduit strain magnitude were lower in older groups for both sexes. Interestingly, whereas RA active EmF increased with age, contractile strain magnitude decreased. Considerable geographic variations were identified: Asians of both sexes had significantly lower BSA than non-Asians, and their 2D and 3D end-systolic RAVs were

Published
2021

5. Similarities and Differences in Left Ventricular Size and Function among Races and Nationalities: Results of the World Alliance Societies of Echocardiography Normal Values Study

Author

Asch, F, Miyoshi, T, Addetia, K, Citro, R, Daimon, M, Desale, S, Fajardo, P, Kasliwal, R, Kirkpatrick, J, Monaghan, M, Muraru, D, Ogunyankin, K, Park, S, Ronderos, R, Sadeghpour, A, Scalia, G, Takeuchi, M, Tsang, W, Tucay, E, Tude Rodrigues, A, Vivekanandan, A, Zhang, Y, Blitz, A, Lang, R, Prado, A, Filipini, E, Kwon, A, Hoschke-Edwards, S, Afonso, T, Thampinathan, B, Sooriyakanthan, M, Zhu, T, Wang, Z, Wang, Y, Zhang, M, Yin, L, Li, S, Alagesan, R, Balasubramanian, S, Ananth, R, Bansal, M, Badano, L, Palermo, C, Bossone, E, Di Vece, D, Bellino, M, Nakao, T, Kawata, T, Hirokawa, M, Sawada, N, Nabeshima, Y, Yun, H, Hwang, J, Fasawe, D, Schreckenberg, M, Amuthan, V, Gutierrez-Fajardo, P, Woo Park, S, Asch F. M., Miyoshi T., Addetia K., Citro R., Daimon M., Desale S., Fajardo P. G., Kasliwal R. R., Kirkpatrick J. N., Monaghan M. J., Muraru D., Ogunyankin K. O., Park S. W., Ronderos R. E., Sadeghpour A., Scalia G. M., Takeuchi M., Tsang W., Tucay E. S., Tude Rodrigues A. C., Vivekanandan A., Zhang Y., Blitz A., Lang R. M., Prado A. D., Filipini E., Kwon A., Hoschke-Edwards S., Afonso T. R., Thampinathan B., Sooriyakanthan M., Zhu T., Wang Z., Wang Y., Zhang M., Yin L., Li S., Alagesan R., Balasubramanian S., Ananth R. V. A., Bansal M., Badano L., Palermo C., Bossone E., Di Vece D., Bellino M., Nakao T., Kawata T., Hirokawa M., Sawada N., Nabeshima Y., Yun H. R., Hwang J. -W., Fasawe D., Schreckenberg M., Ronderos R., Scalia G., Amuthan V., Kasliwal R., Gutierrez-Fajardo P., Woo Park S., Kirkpatrick J., Asch, F, Miyoshi, T, Addetia, K, Citro, R, Daimon, M, Desale, S, Fajardo, P, Kasliwal, R, Kirkpatrick, J, Monaghan, M, Muraru, D, Ogunyankin, K, Park, S, Ronderos, R, Sadeghpour, A, Scalia, G, Takeuchi, M, Tsang, W, Tucay, E, Tude Rodrigues, A, Vivekanandan, A, Zhang, Y, Blitz, A, Lang, R, Prado, A, Filipini, E, Kwon, A, Hoschke-Edwards, S, Afonso, T, Thampinathan, B, Sooriyakanthan, M, Zhu, T, Wang, Z, Wang, Y, Zhang, M, Yin, L, Li, S, Alagesan, R, Balasubramanian, S, Ananth, R, Bansal, M, Badano, L, Palermo, C, Bossone, E, Di Vece, D, Bellino, M, Nakao, T, Kawata, T, Hirokawa, M, Sawada, N, Nabeshima, Y, Yun, H, Hwang, J, Fasawe, D, Schreckenberg, M, Amuthan, V, Gutierrez-Fajardo, P, Woo Park, S, Asch F. M., Miyoshi T., Addetia K., Citro R., Daimon M., Desale S., Fajardo P. G., Kasliwal R. R., Kirkpatrick J. N., Monaghan M. J., Muraru D., Ogunyankin K. O., Park S. W., Ronderos R. E., Sadeghpour A., Scalia G. M., Takeuchi M., Tsang W., Tucay E. S., Tude Rodrigues A. C., Vivekanandan A., Zhang Y., Blitz A., Lang R. M., Prado A. D., Filipini E., Kwon A., Hoschke-Edwards S., Afonso T. R., Thampinathan B., Sooriyakanthan M., Zhu T., Wang Z., Wang Y., Zhang M., Yin L., Li S., Alagesan R., Balasubramanian S., Ananth R. V. A., Bansal M., Badano L., Palermo C., Bossone E., Di Vece D., Bellino M., Nakao T., Kawata T., Hirokawa M., Sawada N., Nabeshima Y., Yun H. R., Hwang J. -W., Fasawe D., Schreckenberg M., Ronderos R., Scalia G., Amuthan V., Kasliwal R., Gutierrez-Fajardo P., Woo Park S., and Kirkpatrick J.

Abstract

Background: The World Alliance Societies of Echocardiography (WASE) Normal Values Study evaluates individuals from multiple countries and races with the aim of describing normative values that could be applied to the global community worldwide and to determine differences and similarities among people from different countries and races. The present report focuses specifically on two-dimensional (2D) left ventricular (LV) dimensions, volumes, and systolic function. Methods: The WASE Normal Values Study is a multicenter international, observational, prospective, cross-sectional study of healthy adult individuals. Participants recruited in each country were evenly distributed among six predetermined subgroups according to age and gender. Comprehensive 2D transthoracic echocardiograms were acquired and analyzed following strict protocols based on recent American Society of Echocardiography and European Association of Cardiovascular Imaging guidelines. Analysis was performed at the WASE 2D core laboratory and included 2D LV dimensions, LV volumes, and LV ejection fraction (LVEF) by the biplane Simpson method and global longitudinal strain (GLS). Results: Two thousand eight subjects were enrolled in 15 countries. The median age was 45 years (interquartile range, 32–65 years), 42.8% were white, 41.8% were Asian, and 9.7% were black. LV dimensions and volumes were larger in male subjects, while LVEF and GLS were higher in female subjects. Global WASE normal ranges for LV dimensions were smaller than those in the guidelines, but the upper limits of normal for LV volumes and the lower limits of normal for LVEF were higher in the WASE study. Significant intercountry variation was identified for all LV parameters reflecting LV size (dimensions, mass, and volumes) even after indexing to body surface area, with LV end-diastolic and end-systolic volumes having the highest variation. The largest volumes were noted in Australia, while the smallest were measured in India for both gen

Published
2019

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