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Published on: February 20, 2017
Reference Values for Indexed Echocardiographic Chamber Sizes in Older Adults: The Multi-Ethnic Study of
Jordan B Strom1, Monica Mukherjee2, Lauren Beussink-Nelson3
1Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center Harvard Medical School 375 Longwood Avenue, 4th Floor Boston MA USA.
Insights
Echocardiographic measurements may misclassify individuals with obesity. This study provides normative values for cardiac chamber measurements using various body size indexation methods in a diverse older adult cohort.
Area of Science:
- Cardiology
- Biometrics
- Gerontology
Background:
- Standard echocardiographic measurements indexed to body surface area (BSA) may misclassify individuals with obesity or sarcopenia.
- Alternative body size normalization methods are needed but lack normative data.
- Understanding these associations is crucial for accurate cardiovascular assessment.
Purpose of the Study:
- To derive normative values for cardiac chamber measurements using diverse indexation methods.
- To assess the association of these parameters with cardiovascular function.
- To provide reference values for a diverse population.
Main Methods:
- Comprehensive 2D echocardiography performed on 3032 individuals in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort.
- Analysis focused on 608 disease-free individuals to derive normative values.
- Measurements were indexed using ratiometric (BSA, BMI, height) and allometric (height^1.6, height^2.7) scaling parameters.
Main Results:
- Normative values were established for left and right cardiac chamber measurements across multiple scaling parameters.
- Reference values were stratified by age, sex, and race/ethnicity.
- Body surface area and height showed least variability across race/ethnicity; height^2.7 showed least variability across sex.
Conclusions:
- This study provides crucial normative values for echocardiographic parameters across various indexation methods in a diverse cohort.
- Findings support the use of alternative indexation methods for more accurate cardiac assessment, especially in individuals with varying body compositions.
- The data aids in better interpretation of echocardiographic findings in community-dwelling older adults.
Background:
Normalization of echocardiographic chamber measurements for body surface area may result in misclassification of individuals with obesity or sarcopenia. Normalization for alternative measures of body size may be preferable, but there remains a dearth of information on their normative values and association with cardiovascular function metrics.
Methods And Results:
A total of 3032 individuals underwent comprehensive 2-dimensional echocardiography at Exam 6 in MESA (Multi-Ethnic Study of Atherosclerosis). In the subgroup of 608 individuals free of cardiopulmonary disease (69.5±7.0 years, 46% male, 48% White, 17% Chinese, 15% Black, 21% Hispanic), normative values were derived for left and right cardiac chamber measurements across a variety of ratiometric (body surface area, body mass index, height) and allometric (height1.6, height2.7) scaling parameters. Normative upper and lower reference values were provided for each scaling parameter stratified across age groups, sex, and race or ethnicity. Among scaling parameters, body surface area and height were associated with the least variability across race and ethnicity categories and height2.7 was associated with the least variability across sex categories.
Conclusions:
In this diverse cohort of community-dwelling older adults, we provide normative values for common echocardiographic parameters across a variety of indexation methods.
