Normal Values of Cardiac Output and Stroke Volume According to Measurement Technique, Age, Sex, and Ethnicity: Results of the World Alliance of Societies of Echocardiography Study.
Cardiac output
Doppler
Stroke volume
Ventricular function
Journal
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
ISSN: 1097-6795
Titre abrégé: J Am Soc Echocardiogr
Pays: United States
ID NLM: 8801388
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
15
03
2021
revised:
16
05
2021
accepted:
17
05
2021
pubmed:
28
5
2021
medline:
16
2
2022
entrez:
27
5
2021
Statut:
ppublish
Résumé
Assessment of cardiac output (CO) and stroke volume (SV) is essential to understand cardiac function and hemodynamics. These parameters can be examined using three echocardiographic techniques (pulsed-wave Doppler, two-dimensional [2D], and three-dimensional [3D]). Whether these methods can be used interchangeably is unclear. The influence of age, sex, and ethnicity on CO and SV has also not been examined in depth. In this report from the World Alliance of Societies of Echocardiography Normal Values Study, the authors compare CO and SV in healthy adults according to age, sex, ethnicity, and measurement techniques. A total of 1,450 adult subjects (53% men) free of heart, lung, and kidney disease were prospectively enrolled in 15 countries, with even distributions among age groups and sex. Subjects were divided into three age groups (young, 18-40 years; middle aged, 41-65 years; and old, >65 years) and three main racial groups (whites, blacks, and Asians). CO and SV were indexed (cardiac index [CI] and SV index [SVI], respectively) to body surface area and height and measured using three echocardiographic methods: Doppler, 2D, and 3D. Images were analyzed at two core laboratories (one each for 2D and 3D). CI and SVI were significantly lower by 2D compared with both Doppler and 3D methods in both sexes. SVI was significantly lower in women than men by all three methods, while CI differed only by 2D. SVI decreased with aging by all three techniques, whereas CI declined only with 2D and 3D. CO and SV were smallest in Asians and largest in whites, and the differences persisted after normalization for body surface area. The present results provide normal reference values for CO and SV, which differ by age, sex, and race. Furthermore, CI and SVI measurements by the different echocardiographic techniques are not interchangeable. All these factors need to be taken into account when evaluating cardiac function and hemodynamics in individual patients.
Sections du résumé
BACKGROUND
Assessment of cardiac output (CO) and stroke volume (SV) is essential to understand cardiac function and hemodynamics. These parameters can be examined using three echocardiographic techniques (pulsed-wave Doppler, two-dimensional [2D], and three-dimensional [3D]). Whether these methods can be used interchangeably is unclear. The influence of age, sex, and ethnicity on CO and SV has also not been examined in depth. In this report from the World Alliance of Societies of Echocardiography Normal Values Study, the authors compare CO and SV in healthy adults according to age, sex, ethnicity, and measurement techniques.
METHODS
A total of 1,450 adult subjects (53% men) free of heart, lung, and kidney disease were prospectively enrolled in 15 countries, with even distributions among age groups and sex. Subjects were divided into three age groups (young, 18-40 years; middle aged, 41-65 years; and old, >65 years) and three main racial groups (whites, blacks, and Asians). CO and SV were indexed (cardiac index [CI] and SV index [SVI], respectively) to body surface area and height and measured using three echocardiographic methods: Doppler, 2D, and 3D. Images were analyzed at two core laboratories (one each for 2D and 3D).
RESULTS
CI and SVI were significantly lower by 2D compared with both Doppler and 3D methods in both sexes. SVI was significantly lower in women than men by all three methods, while CI differed only by 2D. SVI decreased with aging by all three techniques, whereas CI declined only with 2D and 3D. CO and SV were smallest in Asians and largest in whites, and the differences persisted after normalization for body surface area.
CONCLUSIONS
The present results provide normal reference values for CO and SV, which differ by age, sex, and race. Furthermore, CI and SVI measurements by the different echocardiographic techniques are not interchangeable. All these factors need to be taken into account when evaluating cardiac function and hemodynamics in individual patients.
Identifiants
pubmed: 34044105
pii: S0894-7317(21)00493-4
doi: 10.1016/j.echo.2021.05.012
pmc: PMC9149664
mid: NIHMS1796345
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1077-1085.e1Subventions
Organisme : NHLBI NIH HHS
ID : T32 HL007381
Pays : United States
Investigateurs
Aldo D Prado
(AD)
Eduardo Filipini
(E)
Agatha Kwon
(A)
Samantha Hoschke-Edwards
(S)
Tania Regina Afonso
(TR)
Babitha Thampinathan
(B)
Maala Sooriyakanthan
(M)
Tiangang Zhu
(T)
Zhilong Wang
(Z)
Yingbin Wang
(Y)
Lixue Yin
(L)
Shuang Li
(S)
R Alagesan
(R)
S Balasubramanian
(S)
R V A Ananth
(RVA)
Manish Bansal
(M)
Azin Alizadehasl
(A)
Luigi Badano
(L)
Eduardo Bossone
(E)
Davide Di Vece
(D)
Michele Bellino
(M)
Tomoko Nakao
(T)
Takayuki Kawata
(T)
Megumi Hirokawa
(M)
Naoko Sawada
(N)
Yousuke Nabeshima
(Y)
Hye Rim Yun
(HR)
Ji-Won Hwang
(JW)
Commentaires et corrections
Type : ErratumIn
Informations de copyright
Copyright © 2021 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.
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