title: CMR reference values for left ventricular volumes, mass, and ejection fraction using computer-aided analysis: the Framingham Heart Study.
abstract: OBJECTIVE
  To determine sex-specific reference values for left ventricular (LV) volumes, mass, and ejection fraction (EF) in healthy adults using computer-aided analysis and to examine the effect of age on LV parameters.
  
  
  METHODS
  We examined data from 1494 members of the Framingham Heart Study Offspring cohort, obtained using short-axis stack cine SSFP CMR, identified a healthy reference group (without cardiovascular disease, hypertension, or LV wall motion abnormality) and determined sex-specific upper 95th percentile thresholds for LV volumes and mass, and lower 5th percentile thresholds for EF using computer-assisted border detection. In secondary analyses, we stratified participants by age-decade and tested for linear trend across age groups.
  
  
  RESULTS
  The reference group comprised 685 adults (423F; 61 ± 9 years). Men had greater LV volumes and mass, before and after indexation to common measures of body size (all P = 0.001). Women had greater EF (73 ± 6 versus 71 ± 6%; P = 0.0002). LV volumes decreased with greater age in both sexes, even after indexation. Indexed LV mass did not vary with age. LV EF and concentricity increased with greater age in both sexes.
  
  
  CONCLUSIONS
  We present CMR-derived LV reference values. There are significant age and sex differences in LV volumes, EF, and geometry, whereas mass differs between sexes but not age groups.
authors.affiliation: The NHLBI's Framingham Heart Study, Framingham, Massachusetts, USA; Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Chuang
authors.forename: Philimon
authors.initials: P
authors.lastname: Gona
authors.forename: Gilion L T F
authors.initials: GL
authors.lastname: Hautvast
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Salton
authors.forename: Marcel
authors.initials: M
authors.lastname: Breeuwer
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: O'Donnell
authors.forename: Warren J
authors.initials: WJ
authors.lastname: Manning
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000465:Algorithms; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000502:physiology; D010363:Pattern Recognition, Automated / Q000379:methods; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: aging; automated border detection; epidemiology; left ventricle; magnetic resonance imaging; reference values