title: Reference ranges and determinants of right ventricle outflow tract acceleration time in healthy adults by two-dimensional echocardiography.
abstract: The right ventricular outflow tract acceleration time (RVOT-AT) has shown to progressively shorten with increasing degrees of pulmonary pressure. However, the physiologic ranges of RVOT AT are based on small sample sizes and have not been investigated regarding their determining factors. The aim of this study was to investigate reference values and determining factors of RVOT-AT in a large population of healthy subjects and by values described in the literature. In the first part of the study, 1029 healthy subjects (mean age 45.6 ± 16.0 years, 565 (54.7 %) females) were prospectively assessed by clinical examination including demography, vital signs and echocardiography. In the second part, we performed a pooled analysis of eight published studies describing RVOT-AT in healthy subjects (n = 450). Statistical analysis included the calculation of 5 % quantiles for defining reference values. RVOT-AT significantly but weakly correlated with age (r: -0.207; p < 0.001), body mass Index (r: -0.16), systolic (r: -0.158) and diastolic (r: -0.137) blood pressure, heart rate (r: -0.197) and left ventricular (LV) E/A ratio (r: 0.229) (all p < 0.001). No differences were found with regards to sex. In a synopsis of both prospective and literature-based data sets, RVOT-AT weighted means was 138.51 ms and the 5 % quantile was 104.7 ms (95 % confidence interval 98.2-110.1). This study delineates the range of RVOT-AT in healthy adults and it's determining factors. Our study is in line with the cut-off value stated by the European guidelines with an RVOT-AT ≤105 ms denoting abnormal values.
authors.affiliation: IRCCS S.D.N., Via Gianturco 113, 80143, Naples, Italy.
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Marra
authors.affiliation: Pulmonary Hypertension Center, Thoraxclinic at University of Heidelberg, Heidelberg, Germany.
authors.forename: Nicola
authors.initials: N
authors.lastname: Benjamin
authors.affiliation: Department of Cardiology and Cardiac Surgery, University Hospital "Scuola Medica Salernitana", Salerno, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ferrara
authors.affiliation: Department of Emergency and Cardiology, "S. Antonio" Community Hospital, San Daniele del Friuli, UD, Italy.
authors.forename: Olga
authors.initials: O
authors.lastname: Vriz
authors.affiliation: Department of Cardiology, Monaldi Hospital, Second University of Naples, Naples, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: D'Alto
authors.affiliation: Department of Cardiology, Monaldi Hospital, Second University of Naples, Naples, Italy.
authors.forename: Antonello
authors.initials: A
authors.lastname: D'Andrea
authors.affiliation: Department of Respiratory Diseases, Monaldi Hospital, University Federico II, Naples, Italy.
authors.forename: Anna Agnese
authors.initials: AA
authors.lastname: Stanziola
authors.affiliation: Institute of Clinical Physiology, National Research Council, Pisa, Italy.
authors.forename: Luna
authors.initials: L
authors.lastname: Gargani
authors.affiliation: Department of Translational Medical Sciences, Federico II University, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cittadini
authors.affiliation: Pulmonary Hypertension Center, Thoraxclinic at University of Heidelberg, Heidelberg, Germany.
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Grünig
authors.affiliation: Department of Cardiology and Cardiac Surgery, University Hospital "Scuola Medica Salernitana", Salerno, Italy. ebossone@hotmail.com.|Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno - Italy, Via Pr. Amedeo, 36, 83023, Lauro, AV, Italy. ebossone@hotmail.com.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bossone
mesh_terms: D000054:Acceleration; D000328:Adult; D001696:Biomechanical Phenomena; D015150:Echocardiography, Doppler / Q000379:methods / Q000592:standards*; D005260:Female; D064368:Healthy Volunteers; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D017410:Practice Guidelines as Topic / Q000592:standards; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012016:Reference Values; D015203:Reproducibility of Results; D013997:Time Factors; D016278:Ventricular Function, Right
keywords: Echocardiography; Healthy; RVOT-AT; Reference ranges; Risk stratification