Reference Values for Real Time Three‐Dimensional Echocardiography–Derived Left Ventricular Volumes and Ejection Fraction: Review and Meta‐Analysis of Currently Available Studies

Publisher： John Wiley & Sons Inc

E-ISSN： 1540-8175|32|12|1841-1850

ISSN： 0742-2822

Source： ECHOCARDIOGRAPHY (ELECTRONIC), Vol.32, Iss.12, 2015-12, pp. : 1841-1850

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Abstract

IntroductionCurrent guidelines recommend three‐dimensional echocardiography (3DE) as the reference technique to assess left ventricular (LV) volumes and ejection fraction (EF). We performed a meta‐analysis to identify normative reference values by real time 3DE in healthy subjects.MethodsWe searched MEDLINE and the Cochrane Library databases using the key search terms three‐dimensional echocardiography, volumes, and healthy. Data were pooled using random‐effects meta‐analysis, and source of variation was investigated using meta‐regression. After selection, 13 articles were included (2806 subjects). Four studies were conducted in children and young adolescents; one study provided data in an independent pediatric subgroup.ResultsIn adults, pooled mean value for LV EDV was 98.4 mL (95%CI, 87–110 mL), while LV ESV mean value was 37.0 mL (95%CI, 32–42 mL). LV EF mean value was 62.9% (95%CI 61.7–64.2%). Male subjects showed a significant increase in both LV EDV index (mean difference 5.3 mL/m2; P < 0.001) and LV ESV index (mean difference 3.3 mL/m2; P < 0.001). LV EF was significantly higher in female subjects (P = 0.003). In pediatric studies, LV EDV pooled mean value was 53.1 mL (95%CI, 38.1–68 mL), while for LV ESV, it was 19.8 mL (95%CI, 14.8–24.8 mL); LV EF mean value was 63.3% (95%CI, 61.6–65%). Significant heterogeneity and inconsistency were noted among studies. Age, systolic blood pressure, and heart rate were identified as a source of between‐studies variation for LV volumes. Body surface area was a predictor of nonindexed LV volumes.ConclusionsData from available studies of normative values for 3DE were summarized. Our findings may increase the generalizability of LV normative data by 3DE.