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Age- and Sex-Specific Reference Values for Atrial and Ventricular Structures in the Validated Normal Chinese
Baiyan Zhuang1, Shuang Li1, Jing Xu1
1Department of Magnetic Resonance Imaging, Cardiovascular imaging and intervention Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Insights
This study establishes normal cardiac structure reference values for Chinese adults, revealing significant sex and age-related differences in cardiac dimensions. These findings are crucial for accurate diagnosis and management of cardiovascular conditions in this population.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Statistics
Background:
- Cardiac structure dimensions are vital prognostic indicators in various cardiac disorders.
- Left and right cardiac structures serve as key biomarkers in heart failure and disease assessment.
Purpose of the Study:
- To establish age- and sex-specific reference values for normal cardiac structures in Chinese adults.
- To provide a normative dataset for cardiac morphology in a healthy Chinese adult population.
Main Methods:
- A prospective study involving 200 healthy Chinese adults (100 males, 100 females) across five age deciles (20-70 years).
- Cardiac imaging was performed using 3.0T MRI with steady-state free precession (SSFP) and turbo spin-echo (TSE) sequences.
- Measurements were normalized to age, sex, and body surface area (BSA), with statistical analyses including t-tests, ANOVA, and regression.
Main Results:
- Significant sex-based differences were observed: females had larger normalized left atrial (LA) transverse diameter and left ventricular outflow tract (LVOT) diameter, while males had higher LA volume.
- Advancing age correlated with a decrease in normalized LA transverse diameter, normalized right atrial (RA) volume, and right ventricular outflow tract (RVOT) diameter.
- Indexed ventricular volumes generally decreased with age, and LA longitudinal parameters showed strong correlation with LA area.
Conclusions:
- This study provides essential, sex- and age-specific reference ranges for cardiac morphological parameters in the Chinese population.
- These reference values are critical for the accurate interpretation of cardiac imaging and clinical assessment in Chinese adults.
- Understanding these normative variations aids in the early detection and management of cardiovascular diseases.
Background:
Left and right cardiac structures have been shown to provide important prognostic information in patients with various cardiac disorders. They have always been important biomarkers in patients with heart failure and are crucial in the judgment of a variety of heart diseases.
Purpose:
To provide age- and sex-specific reference values of the normal cardiac structure of Chinese adults.
Study Type:
Prospective study.
Population:
In all, 200 healthy adult volunteers with 20 men and 20 women in each of five age deciles from 20 to 70 years.
Field Strength:
3.0T, steady-state free precession (SSFP), turbo spin-echo (TSE) sequence.
Assessment:
The reference range of cardiac structure values was normalized to age, gender, and body surface area (BSA). The height, weight, blood pressure, and body mass index were measured as well.
Statistic Tests:
Kolmogorov-Smirnov's, independent-sample t-tests, one-way analysis of variance (ANOVA), Pearson's coefficient, and linear regression.
Results:
The normalized left atrial (LA) transverse diameter (two-chamber view) at end-systolic, and left ventricular outflow tract diameter (LVOT) were significantly larger in females compared to males (all P < 0.001), while LA volume at end-systole was found higher in males (males: 36.25 ± 10.03 mL vs. females: 32.78 ± 10.27 mL). With increasing age, there was a weak but significant decrease in normalized LA transverse diameter (two-chamber view) at end- systolic (r = -0.25, P < 0.001). The normalized RA volume at end-systole and RVOT diameter showed significant decrease with advancing age (r = -0.22, P = 0.002; r = -0.34, P < 0.001). The indexed left and right ventricular volumes were mostly smaller with advancing age. The LA longitudinal parameters correlated significantly with LA area measured in the two-chamber view at end-systole (r = 0.78, P < 0.001).
Data Conclusion:
Reference values for the morphological parameters of the intracardiac structure by sex and age distribution are provided in a Chinese population.
Level Of Evidence:
2 TECHNICAL EFFICACY: Stage 5 J. Magn. Reson. Imaging 2020;52:1031-1043.
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