Cardiovascular Magnetic Resonance Reference Values for Left Ventricular Diastolic Function and Left Atrial Sphericity...

Cardiovascular magnetic resonance (CMR) is increasingly used to quantify volumetric indices reflecting left ventricular (LV) diastolic function. However, normal reference values for CMR-derived volumetric parameters of LV diastolic function and the left atrial sphericity index (LASI) remain limited. This study aimed to establish age- and sex-specific reference values for CMR-derived LV diastolic volumetric parameters and LASI in a large cohort of healthy Chinese adults.

A total of 503 healthy Chinese adults, rigorously validated by comprehensive health screening, were retrospectively included. A structured literature review was performed to identify candidate CMR-derived volumetric parameters of LV diastolic function, as well as LASI. Based on this review, left atrioventricular coupling index (LACI), left atrial expansion index (LAEI), peak filling rate (PFR), PFR normalized to end-diastolic volume (PFR/EDV), CMR-derived left ventricular filling pressure (LVFP), and LASI were selected and measured from cine CMR images. Reference values were calculated and stratified by sex and age decades. Associations of these CMR-derived parameters with sex and age were evaluated.

Men exhibited significantly lower LACI [0.19 (0.15-0.24) vs. 0.20 (0.17-0.25)], LAEI [146.9 (122.5-181.2) % vs. 161.4 (139.6-202.4) %], PFR/EDV [2.61 (2.25-3.09) s^-1 vs. 2.97 (2.51-3.32) s^-1], and LASI [0.52 (0.46-0.62) vs. 0.59 (0.50-0.68)], but higher absolute PFR [385.4 (325.4-442.6) mL/s vs. 341.2 (290.9-394.9) mL/s] and CMR-derived LVFP [13.2 (12.4-14.4) mmHg vs. 12.3 (11.4-13.1) mmHg] than women (all p < 0.05). With advancing age, LACI increased progressively in both sexes (men: r = 0.20; women: r = 0.24; both p < 0.001), whereas LAEI, PFR, PFR/EDV, and LASI exhibited significant declines (men: r = -0.25, -0.33, -0.21, and -0.22; women: r = -0.22, -0.36, -0.26, and -0.32; all p < 0.001).

This study provides age- and sex-specific reference values for CMR-derived LV diastolic volumetric parameters and LASI in a large cohort of validated healthy Chinese adults. Both age and sex significantly influence these parameters. These normative data support standardized interpretation of CMR-derived diastolic parameters in clinical and research settings, particularly for the Chinese population.