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Scaling Echocardiographic Cardiac Dimensions to Body Size: A Bayesian Analysis in Healthy Men and Women
Ignacio Iglesias-Garriz1, David Alonso2, Carmen Garrote2
1Department of Cardiology, Complejo Asistencial Universitario de Leon, Leon, Spain. jiiglesias@saludcastillayleon.es.
Insights
Accurate cardiac dimension scaling is crucial for clinical cardiology. This study found that optimal allometric coefficients (ACs) for scaling differ from standard isometric assumptions, impacting size estimations.
Area of Science:
- Cardiology
- Biometry
- Physiology
Background:
- Accurate scaling of cardiac dimensions is vital for clinical cardiology decisions.
- Current normalization methods often assume an isometric relationship between cardiac size and body size.
- Investigating optimal allometric coefficients (ACs) is necessary for precise scaling.
Purpose of the Study:
- To determine the best allometric coefficients (ACs) for scaling various cardiac dimensions.
- To compare these ACs with traditional isometric coefficients.
- To assess the impact of using incorrect scaling factors on cardiac structure size estimations.
Main Methods:
- Ninety-seven healthy volunteers were analyzed.
- Cardiac dimensions scaled included left atrial volume, left ventricular volumes (end-diastolic and end-systolic), and tricuspid annulus diameter.
- Bayesian statistical analysis was employed with isometric coefficients as priors.
Main Results:
- Linear correlations between cardiac dimensions and body size varied, with modest ranges observed.
- Allometric coefficients (ACs) differed across cardiac dimensions and body size measurements.
- For left atrial volume-weight and end-diastolic volume-height, isometric coefficients fell outside the 95% highest density interval, indicating non-isometric relationships.
Conclusions:
- The determined allometric coefficients (ACs) for cardiac structure scaling differ from standard isometric coefficients and often from 1.
- These findings necessitate consideration when normalizing cardiac structures to body size in clinical practice.
- Failure to use appropriate ACs can lead to significant errors in cardiac size estimations.
Background:
Proper scaling of cardiac dimensions is of paramount importance in making correct decisions in clinical cardiology. The usual normalization of cardiac dimensions to overall body size assumes an isometric relationship. We sought to investigate these relationships to obtain the best allometric coefficient (AC) for scaling.
Methods:
Ninety-seven healthy volunteers were included. The dimensions to be scaled were the left atrial volume, the end-diastolic and end-systolic left ventricular volumes, and the diameter of the tricuspid annulus. A Bayesian statistical analysis was applied with isometric coefficients as priors.
Results:
The linear correlations between cardiac dimensions and body size were modest, ranging from 0.12 (-0.10-0.32) for the left atrial volume and height to 0.70 (0.58-0.80) for the end-diastolic volume and height. The ACs varied across the different cardiac dimensions and body size measurements. For the best linear relationships, the isometric coefficients were outside the 95% highest density interval of the posterior distribution for the left atrial volume-weight (AC: 0.7; 0.4-0.9) and end-diastolic volume-height (AC: 2.3; 1.7-2.9), whereas they were different from 1 for the left atrial volume-weight, end-diastolic volume, and diameter of the tricuspid annulus-body surface area (AC: 0.6; 0.3-0.8). Not scaling the cardiac dimensions to their corresponding ACs can lead to important errors in size estimations of cardiac structure.
Conclusions:
The ACs found in this study are somewhat different from the corresponding isometric coefficients and often different from 1. This finding should be considered when normalizing cardiac structures to body size when making clinical decisions.
