The case for indexing: Echocardiographic dimensions in the Arab Gulf

To evaluate echocardiographic parameters in young Emirati males and compare them to American Society of Echocardiography/European Association of Cardiovascular Imaging reference ranges, highlighting the need for population-specific or indexed normal ranges. Echocardiographic reference ranges for cardiac dimensions are primarily derived from Western populations, which may not be suitable for smaller-bodied populations, such as Asians.

Echocardiography was performed on 60 healthy Emirati males undergoing military recruitment from September to December 2024. Measurements included left ventricular (LV), aortic, and left atrial (LA) dimensions and volumes. Parameters were indexed to body surface area (BSA) and compared to established Western norms.

Left ventricular end-diastolic (38-54 mm) and end-systolic dimensions (23-36 mm) were smaller than Western ranges which are 42-58 mm for end-diastolic and 25-40 mm for endsystolic dimensions. Aortic dimensions were also smaller, including the annulus (17-27 mm) and ascending aorta (18-30 mm). Indexed measurements resolved discrepancies, aligning with global standards. Left atrial dimensions (22-41 mm) were comparable to Western norms, while biplane LA volumes (11-30 ml/m²) and 3D volumes (11-28 ml/m²) were lower.

Significant differences exist between cardiac dimensions in Emirati males and Western reference ranges. Indexing to BSA addresses these discrepancies, emphasizing the need for indexed ranges to ensure accurate diagnoses and timely interventions, particularly in diverse populations globally.