Sex- and Age-Related Reference Values in Cardiology, with Annotations and Guidelines for Interpretation

Area of Science:

• Cardiology
• Clinical Sciences
• Biomedical Sciences

Background:

• Clinical abnormality is defined by reference values, often derived from mean ± 2 standard deviations or percentiles.
• Measurement accuracy varies by data collection and analysis methods (e.g., 2D echocardiography vs. MRI), necessitating modality-specific reference values.
• Reference values are essential for disease suspicion and confirmation based on exceeding established normal ranges.

Purpose of the Study:

• To review and summarize established reference values for cardiovascular parameters.
• To highlight sex- and age-specific differences in these reference values.
• To emphasize the importance of considering various influencing factors like body size, training, and ethnicity.

Main Methods:

• Literature review summarizing existing reference values.
• Focus on electrocardiogram, cardiac volumes, and arterial dimensions.
• Inclusion of sex, age, body size, training status, and ethnicity as relevant variables.

Main Results:

• Compilation of reference values for electrocardiogram, cardiac volumes, and arterial size across different demographics.
• Demonstration of significant sex- and age-specific variations in these cardiovascular parameters.
• Acknowledgement of other relevant factors like microcirculation and biomarkers, referencing existing literature.

Conclusions:

• Sex- and age-specific reference values for cardiovascular measurements are critical for accurate interpretation.
• Observed differences are often significant and require consideration in both clinical practice and research.
• Modality-specific reference values are necessary due to variations in measurement techniques.