Reference Values for Indexed Echocardiographic Chamber Sizes in Older Adults: The Multi‐Ethnic Study of Atherosclerosis

Background Normalization of echocardiographic chamber measurements for body surface area may result in misclassification of individuals with obesity or sarcopenia. Normalization for alternative measures of body size may be preferable, but there remains a dearth of information on their normative values and association with cardiovascular function metrics. Methods and Results A total of 3032 individuals underwent comprehensive 2‐dimensional echocardiography at Exam 6 in MESA (Multi‐Ethnic Study of Atherosclerosis). In the subgroup of 608 individuals free of cardiopulmonary disease (69.5±7.0 years, 46% male, 48% White, 17% Chinese, 15% Black, 21% Hispanic), normative values were derived for left and right cardiac chamber measurements across a variety of ratiometric (body surface area, body mass index, height) and allometric (height1.6, height2.7) scaling parameters. Normative upper and lower reference values were provided for each scaling parameter stratified across age groups, sex, and race or ethnicity. Among scaling parameters, body surface area and height were associated with the least variability across race and ethnicity categories and height2.7 was associated with the least variability across sex categories. Conclusions In this diverse cohort of community‐dwelling older adults, we provide normative values for common echocardiographic parameters across a variety of indexation methods.