title: Echocardiographic reference ranges for normal cardiac Doppler data: results from the NORRE Study.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Caballero
authors.affiliation: Department of Cardiology, St. Marianna University, School of Medicine, Kawasaki, Japan.
authors.forename: Seisyou
authors.initials: S
authors.lastname: Kou
authors.affiliation: University of Liège Hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liège, Belgium.
authors.forename: Raluca
authors.initials: R
authors.lastname: Dulgheru
authors.affiliation: Echocardiography Laboratory of Adult Cardiology Department of the JO ANN Medical Center, Tbilisi, Georgia.
authors.forename: Natalia
authors.initials: N
authors.lastname: Gonjilashvili
authors.affiliation: Noninvasive Diagnostics Department-Onassis Cardiac Surgery Center, Athens, Greece.
authors.forename: George D
authors.initials: GD
authors.lastname: Athanassopoulos
authors.affiliation: Laboratory of Cardiovascular Ecography-Cardiology Dpt-S. Andrea Hospital, La Spezia, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Barone
authors.affiliation: Laboratorio Di Ecocardiografia Adulti, Fondazione Toscana 'G.Monasterio'-Ospedale Del Cuore, Massa, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Baroni
authors.affiliation: Echocardiography Laboratory, Hospital da Luz, Lisbon, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Cardim
authors.affiliation: Unidad de Imagen - Cardiovascular. ICV. Hospital Clinico San Carlos, Madrid, Spain.
authors.forename: Jose Juan
authors.initials: JJ
authors.lastname: Gomez de Diego
authors.affiliation: Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Oliva
authors.affiliation: Echokardiographie-Labore des Universitätsklinikums AöR, Department of Cardiology-Angiology, University of Leipzig, Leipzig, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Hagendorff
authors.affiliation: Department of Noninvasive Functional Diagnostic and Imaging, University National Heart Hospital, Sofia, Bulgaria.
authors.forename: Krasimira
authors.initials: K
authors.lastname: Hristova
authors.affiliation: Cardiology Department, La Paz Hospital, Madrid, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Lopez
authors.affiliation: CHU Limoges, Hôpital Dupuytren, Pôle Coeur-Poumon-Rein, Service Cardiologie, Limoges, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Magne
authors.affiliation: University of Liège Hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liège, Belgium.
authors.forename: Christophe
authors.initials: C
authors.lastname: Martinez
authors.affiliation: Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: de la Morena
authors.affiliation: 'Carol Davila' University of Medicine and Pharmacy-Euroecolab, Institute of Cardiovascular Diseases, Bucharest, Romania.
authors.forename: Bogdan A
authors.initials: BA
authors.lastname: Popescu
authors.affiliation: Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium.
authors.forename: Martin
authors.initials: M
authors.lastname: Penicka
authors.affiliation: VKV Amerikan Hastanesi, Kardiyoloji Bölümü, Istanbul, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Ozyigit
authors.affiliation: Laboratorio de Ecocardiografia Hospital de Cruces-Barakaldo, Barakaldo, Spain.
authors.forename: Jose David
authors.initials: JD
authors.lastname: Rodrigo Carbonero
authors.affiliation: SheikhKhalifa Medical City, Abu Dhabi, UAE.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Salustri
authors.affiliation: Echocardiography Unit, AZ Maria Middelares Gent, Gent, Belgium.
authors.forename: Nico
authors.initials: N
authors.lastname: Van De Veire
authors.affiliation: Medical Department Cardiology, Universitätsmedizin of the Johannes Gutenberg-University Mainz, Mainz, Germany.
authors.forename: Ralph Stephan
authors.initials: RS
authors.lastname: Von Bardeleben
authors.affiliation: Cardiovascular Research Unit, University and Emergency Hospital, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
authors.forename: Dragos
authors.initials: D
authors.lastname: Vinereanu
authors.affiliation: Echocardiography Laboratory, Department of Cardiovascular Diseases, University Hospital Gasthuisberg, Leuven, Belgium.
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Voigt
authors.affiliation: University Hospital Ramón y Cajal, Madrid. Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Zamorano
authors.affiliation: CHU Tours, France et Université de Tours, Tours, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Bernard
authors.affiliation: CIC-IT U 804, CHU Rennes, Université Rennes 1, Service de Cardiologie, CHU RENNES, Rennes, France.
authors.forename: Erwan
authors.initials: E
authors.lastname: Donal
authors.affiliation: Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA.
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Lang
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences University of Padova, School of Medicine, Padova, Italy.
authors.forename: Luigi P
authors.initials: LP
authors.lastname: Badano
authors.affiliation: University of Liège Hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liège, Belgium GVM Care and Research, E.S. Health Science Foundation, Lugo, Ravenna, Italy plancellotti@chu.ulg.ac.be.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Lancellotti
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology*; D015331:Cohort Studies; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler / Q000379:methods*; D005060:Europe; D005260:Female; D064368:Healthy Volunteers; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012737:Sex Factors; D013599:Systole / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult
keywords: Doppler echocardiography; NORRE Study; reference values; systolic and diastolic function