3D echocardiographic reference ranges for normal left ventricular volumes and strain: results from the EACVI NORRE study.
OBJECTIVE
To obtain the normal ranges for 3D echocardiography (3DE) measurement of left ventricular (LV) volumes, function, and strain from a large group of healthy volunteers.


RESULTS
A total of 440 (mean age: 45 ± 13 years) out of the 734 healthy subjects enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study had good-quality 3DE data sets that have been analysed with a vendor-independent software package allowing homogeneous measurements regardless of the echocardiographic machine used to acquire the data sets. Upper limits of LV end-diastolic and end-systolic volumes were larger in men (97 and 42 mL/m2) than in women (82 and 35 mL/m2; P < 0.0001). Conversely, lower limits of LV ejection fraction were higher in women than in men (51% vs. 50%; P < 0.01). Similarly, all strain components were higher in women than in men. Lower range was -18.6% in men and -19.5% in women for 3D longitudinal strain, -27.0% and -27.6% for 3D circumferential strain, -33.2% and -34.4% for 3D tangential strain and 38.8% and 40.7% for 3D radial strain, respectively. LV volumes decreased with age in both genders (P < 0.0001), whereas LV ejection fraction increased with age only in men. Among 3DE LV strain components, the only one, which did not change with age was longitudinal strain.


CONCLUSIONS
The NORRE study provides applicable 3D echocardiographic reference ranges for LV function assessment. Our data highlight the importance of age- and gender-specific reference values for both LV volumes and strain.
Departments of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.|Cardiology Department, CHU Tours, France et Université de Tours, Tours, France.
Anne
A
Bernard
Department of Medicine, University of Chicago Medical Center, IL, USA.
Karima
K
Addetia
Departments of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.
Raluca
R
Dulgheru
Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Clinico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain.
Luis
L
Caballero
Departments of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.
Tadafumi
T
Sugimoto
Echocardiography Laboratory of Adult Cardiology Department of the JO ANN Medical Center, Tbilisi, GA.
Natela
N
Akhaladze
Noninvasive Diagnostics Department - Onassis Cardiac Surgery Center, Athens, Greece.
George D
GD
Athanassopoulos
Laboratory of Cardiovascular Ecography, Cardiology Department, S. Andrea Hospital, La Spezia, Italy.
Daniele
D
Barone
Laboratorio Ecocardiografia Adulti, Fondazione Toscana "G.Monasterio"- Ospedale Del Cuore, Massa, Italy.
Monica
M
Baroni
Hospital da Luz, Echocardiography Laboratory, Lisbon, Portugal.
Nuno
N
Cardim
Department of Cardiology-Angiology, Echokardiographie-Labore des Universitätsklinikums AöR, University of Leipzig, Leipzig, Germany.
Andreas
A
Hagendorff
Department of Noninvasive Functional Diagnostic and Imaging, University National Heart Hospital, Sofia, Bulgaria.
Krasimira
K
Hristova
Departments of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.
Federica
F
Ilardi
Cardiology Department, La Paz Hospital, Madrid, Spain.
Teresa
T
Lopez
Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Clinico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain.
Gonzalo
G
de la Morena
"Carol Davila" University of Medicine and Pharmacy - Euroecolab, Institute of Cardiovascular Diseases, Bucharest, Romania.
Bogdan A
BA
Popescu
Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium.
Martin
M
Penicka
VKV Amerikan Hastanesi, Kardiyoloji Bölümü, Istanbul, Turkey.
Tolga
T
Ozyigit
Laboratorio de Ecocardiografia Hospital de Cruces, Barakaldo, Spain.
Jose
J
David Rodrigo Carbonero
Echocardiography Unit, AZ Maria Middelares, Gent, Belgium.
Nico
N
van de Veire
Medical Department Cardiology, Universitätsmedizin of the Johannes Gutenberg, University Mainz, Mainz, Germany.
Ralph
R
Stephan Von Bardeleben
Cardiovascular Research Unit, University and Emergency Hospital, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
Dragos
D
Vinereanu
University Alcala, Hospital Ramón y Cajal, Madrid, Spain.
Jose
J
Luis Zamorano
Departments of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.
Christophe
C
Martinez
CHU Dupuytren, Limoges, France.
Julien
J
Magne
CHVZ (Centrum voor Hart en Vaatziekten), Universitair ziekenhuis Brussel; and ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Brussels, Belgium.
Bernard
B
Cosyns
CIC-IT U 1414, CHU Rennes, Université Rennes 1, Service de Cardiologie, CHU RENNES, France.
Erwan
E
Donal
Aix-Marseille Université, 13005 Marseille France.|Cardiology Department, APHM, La Timone Hospital, Marseille, France.
Gilbert
G
Habib
Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, School of Medicine, Padova, Italy.
Luigi P
LP
Badano
Department of Medicine, University of Chicago Medical Center, IL, USA.
Roberto M
RM
Lang
Departments of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.|Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy.
Patrizio
P
Lancellotti
D000328:Adult; D000368:Aged; D002306:Cardiac Volume / Q000502:physiology*; D019560:Echocardiography, Three-Dimensional; D005260:Female; D064368:Healthy Volunteers; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult
adult echocardiography ; deformation imaging ; left ventricular function ; reference values; three-dimensional echocardiography 