Clinical InvestigationsNormal Values of Left Ventricular Mass by EchocardiographyNormal Values of Left Ventricular Mass by Two-Dimensional and Three-Dimensional Echocardiography: Results from the World Alliance Societies of Echocardiography Normal Values Study
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Study Design and Population
The rationale and design of the WASE study have been previously described in detail.7,12 In the WASE study, a “normal” subject was defined as an adult ≥18 years of age without a history or clinical evidence of heart, lung, or kidney disease; no history of hypertension, dyslipidemia, or diabetes; blood pressure < 140/90 mm Hg; body mass index 20 to 30 kg/m2; and mild or less valvular disease.7 Pregnant women, competitive athletes, and subjects with significant renal insufficiency were excluded.7
Results
Of the 2,008 total subjects, 154 subjects were excluded because of image quality that was deemed unsuitable for LV mass analysis. In total, 1,854 subjects were included in the final analysis. LV mass measurements were feasible by the linear method in 1,685 subjects, the truncated ellipsoid method in 1,423 subjects, the area-length method in 1,423 subjects, and volumetric analysis of 3DE data sets in 992 subjects.
Baseline demographic characteristics are listed in Table 1. Both sexes were equally
Discussion
It is well known that LV mass is an important risk factor and a predictor of cardiovascular morbidity and mortality.1,3, 4, 5,17 To the best of our knowledge, this is the first study to define normative values for LV mass in a large, global cohort of healthy adults using linear, 2DE, and 3DE techniques and to determine how sex, age, and race influence these measurements. We found that (1) there were significant and large intertechnique differences in normal reference values, suggesting that
Conclusion
Our results from the WASE Normal Values Study provide normal reference values for all different methods to calculate LV mass, which differ by age, sex, and race. Importantly, we found that there were significant intertechnique differences in LV mass calculation, suggesting that the various echocardiographic techniques are not interchangeable. Moreover, sex-, age-, and race-related differences underscore the need for separate age-specific normal values for men and women of different ages and
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The WASE study was supported by the American Society of Echocardiography.
Conflicts of Interest: None.
William A. Zoghbi, MD, FASE, served as guest editor for this report.
The WASE Study Investigators are listed in the Appendix.