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Normal reference intervals for cardiac dimensions and function for use in echocardiographic practice: a guideline
Allan Harkness1, Liam Ring2, Daniel X Augustine3
1East Suffolk and North Essex NHS Foundation Trust, Essex, UK
Insights
This guideline updates reference limits for echocardiographic practice, introducing new terminology and emphasizing indexed measures for chamber size assessment. It provides updated parameters for evaluating heart structure and function.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Echocardiography is crucial for assessing cardiac structure and function.
- Previous guidelines from the British Society of Echocardiography require updating.
- Standardized reference limits are essential for accurate echocardiographic interpretation.
Purpose of the Study:
- To present updated reference limits for echocardiographic practice.
- To discuss changes in assessment methodology and terminology for cardiac parameters.
- To provide guidance on interpreting echocardiographic findings within clinical context.
Main Methods:
- Review and update of established echocardiographic reference intervals.
- Discussion of the rationale and definition of new reference limits.
- Inclusion of updated parameters: LV dimensions, mass, volumes, ejection fraction, LA size, right heart, aortic dimensions, and tissue Doppler imaging.
Main Results:
- New reference limits for key echocardiographic parameters are presented.
- Updated terminology for left ventricular function and left atrial size is introduced.
- A new approach to assessing the aortic root and right heart is advocated.
Conclusions:
- The guideline provides updated reference limits for echocardiography.
- New terminology and methods enhance the assessment of cardiac structure and function.
- Emphasis is placed on using indexed measures for chamber size evaluation.
Abstract:
This guideline presents reference limits for use in echocardiographic practice, updating previous guidance from the British Society of Echocardiography. The rationale for change is discussed, in addition to how the reference intervals were defined and the current limitations to their use. The importance of interpretation of echocardiographic parameters within the clinical context is explored, as is grading of abnormality. Each of the following echo parameters are discussed and updated in turn: left ventricular linear dimensions and LV mass; left ventricular volumes; left ventricular ejection fraction; left atrial size; right heart parameters; aortic dimensions; and tissue Doppler imaging. There are several important conceptual changes to the assessment of the heart’s structure and function within this guideline. New terminology for left ventricular function and left atrial size are introduced. The British Society of Echocardiography has advocated a new approach to the assessment of the aortic root, the right heart, and clarified the optimal methodology for assessment of LA size. The British Society of Echocardiography has emphasized a preference to use, where feasible, indexed measures over absolute values for any chamber size.
