title: Right Ventricular Volumes and Systolic Function by Cardiac Magnetic Resonance and the Impact of Sex, Age, and Obesity in a Longitudinally Followed Cohort Free of Pulmonary and Cardiovascular Disease: The Framingham Heart Study.
abstract: BACKGROUND
  Cardiac magnetic resonance is uniquely well suited for noninvasive imaging of the right ventricle. We sought to define normal cardiac magnetic resonance reference values and to identify the main determinants of right ventricular (RV) volumes and systolic function using a modern imaging sequence in a community-dwelling, longitudinally followed cohort free of clinical cardiovascular and pulmonary disease.
  
  
  RESULTS
  The Framingham Heart Study Offspring cohort has been followed since 1971. We scanned 1794 Offspring cohort members using steady-state free precession cardiac magnetic resonance and identified a reference group of 1336 adults (64±9 years, 576 men) free of prevalent cardiovascular and pulmonary disease. RV trabeculations and papillary muscles were considered cavity volume. Men had greater RV volumes and cardiac output before and after indexation to body size (all P<0.001). Women had higher RV ejection fraction than men (68±6% versus 64±7%; P<0.0001). RV volumes and cardiac output decreased with advancing age. There was an increase in raw and height-indexed RV measurements with increasing body mass index, but this trend was weakly inverted after indexation of RV volumes to body surface area. Sex, age, height, body mass index, and heart rate account for most of the variability in RV volumes and function in this community-dwelling population.
  
  
  CONCLUSIONS
  We report sex-specific normative values for RV measurements among principally middle-aged and older adults. RV ejection fraction is greater in women. RV volumes increase with body size, are greater in men, and are smaller in older people. Body surface area seems to be appropriate for indexation of cardiac magnetic resonance-derived RV volumes.
authors.affiliation: From the Department of Medicine, Cardiovascular Division (M.F., A.A., C.J.S., W.J.M., M.L.C.) and Department of Radiology (W.J.M.), Beth Israel Deaconess Medical Center, Boston, MA; Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (M.F.); Department of Medicine, Boston University School of Medicine, MA (G.A., D.L.); The National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA (P.G., S.J.B., D.L., C.J.O., M.L.C.); College of Nursing and Health Sciences, University of Massachusetts, Boston (P.G.); UpToDate, Wolters Kluwer Health, Waltham, MA (S.B.Y.); Cardiology Section, Boston Veteran's Administration Healthcare, MA (C.J.O.); Harvard Medical School, Boston, MA (C.J.O., W.J.M.).
authors.forename: Murilo
authors.initials: M
authors.lastname: Foppa
authors.affiliation: From the Department of Medicine, Cardiovascular Division (M.F., A.A., C.J.S., W.J.M., M.L.C.) and Department of Radiology (W.J.M.), Beth Israel Deaconess Medical Center, Boston, MA; Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (M.F.); Department of Medicine, Boston University School of Medicine, MA (G.A., D.L.); The National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA (P.G., S.J.B., D.L., C.J.O., M.L.C.); College of Nursing and Health Sciences, University of Massachusetts, Boston (P.G.); UpToDate, Wolters Kluwer Health, Waltham, MA (S.B.Y.); Cardiology Section, Boston Veteran's Administration Healthcare, MA (C.J.O.); Harvard Medical School, Boston, MA (C.J.O., W.J.M.).
authors.forename: Garima
authors.initials: G
authors.lastname: Arora
authors.forename: Philimon
authors.initials: P
authors.lastname: Gona
authors.forename: Arman
authors.initials: A
authors.lastname: Ashrafi
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Salton
authors.forename: Susan B
authors.initials: SB
authors.lastname: Yeon
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Blease
authors.forename: Daniel
authors.initials: D
authors.lastname: Levy
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: O'Donnell
authors.forename: Warren J
authors.initials: WJ
authors.lastname: Manning
authors.forename: Michael L
authors.initials: ML
authors.lastname: Chuang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001830:Body Surface Area; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D012016:Reference Values; D012737:Sex Factors; D013318:Stroke Volume; D013599:Systole; D013997:Time Factors; D016278:Ventricular Function, Right
keywords: cardiac MRI; cardiac volume; epidemiology; right ventricle; systolic function