Abstract
Echocardiography is the most common routine cardiac imaging method. Nevertheless, only few data about sex-specific reference limits for right atrium (RA) dimensions are available. Transthoracic echocardiographic RA measurements were studied in 9511 participants of the Gutenberg-Health-Study. A reference sample of 1942 cardiovascular healthy subjects without chronic obstructive pulmonary disease was defined. We assessed RA dimensions and sex-specific reference limits were defined using the 95th percentile of the reference sample. Results showed sex-specific differences with larger RA dimensions in men that were attenuated by standardization for body-height. RA-volume was 20.2 ml/m in women (5th–95th: 12.7–30.4 ml/m) and 26.1 ml/m in men (5th–95th: 16.0–40.5 ml/m). Multivariable regressions identified body-mass-index (BMI), coronary artery disease (CAD), chronic heart failure (CHF) and atrial fibrillation (AF) as independent key correlates of RA-volume in both sexes. All-cause mortality after median follow-up-period of 10.7 (9.81/11.6) years was higher in individuals who had RA volume/height outside the 95% reference limit (HR 1.70 [95%CI 1.29–2.23], P = 0.00014)). Based on a large community-based sample, we present sex-specific reference-values for RA dimensions normalized for height. RA-volume varies with BMI, CHF, CAD and AF in both sexes. Individuals with RA-volume outside the reference limit had a 1.7-fold higher mortality than those within reference limits.
Highlights
Echocardiography is the most common routine cardiac imaging method
Most of the published reference limits are presented as absolute values that were not normalized to body surface area (BSA)[2] or height[6,8,9], which is problematic because body size is a key determinant of cardiac measurements
The objective of the present investigation was to analyze right atrium (RA) dimensions from a large-scale, epidemiological study conducted with state-of-the-art echocardiography imaging technology in order to define sex-specific reference limits for the RA
Summary
Echocardiography is the most common routine cardiac imaging method. only few data about sex-specific reference limits for right atrium (RA) dimensions are available. Based on a large community-based sample, we present sex-specific reference-values for RA dimensions normalized for height. Despite widespread use of echocardiography worldwide, there are very limited data available regarding dimensions of the right atrium (RA)[2,3,6,7]. Lack of such data from population-based studies may potentially contribute to inaccuracies in sex-specific reference limits for RA dimensions in literature. The objective of the present investigation was to analyze RA dimensions from a large-scale, epidemiological study conducted with state-of-the-art echocardiography imaging technology in order to define sex-specific reference limits for the RA
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