Echocardiographic Reference Values Research Articles

Sex-specific echocardiographic reference values: the women's point of view.

: Clinical presentation, diagnosis and outcomes of cardiac diseases are influenced by the activity of sex steroid hormones. These hormonal differences explain the later development of heart diseases in women in comparison with men and the different clinical picture, management and prognosis. Echocardiography is a noninvasive and easily available technique for the analysis of cardiac structure and function. The aim of the present review is to underline the most important echocardiographic differences between sexes. Several echocardiographic studies have found differences in healthy populations between women and men. Sex-specific difference of some of these parameters, such as left ventricular (LV) linear dimensions and left atrial volume, can be explained on the grounds of smaller body size of women, but other parameters (LV volumes, stroke volume and ejection fraction, right ventricular size and systolic function) are specifically lower in women, even after adjusting for body size and age. Sex-specific differences of standard Doppler and Tissue Doppler diastolic indices remain controversial, but it is likely for aging to affect LV diastolic function more in women than in men. Global longitudinal strain appears to be higher in women during the childbearing age - a finding that also highlights a possible hormonal influence in women. All these findings have practical implications, and sex-specific reference values are necessary for the majority of echocardiographic parameters in order to distinguish normalcy from disease. Careful attention on specific cut-off points in women could avoid misinterpretation, inappropriate management and delayed treatment of cardiac diseases such as valvular disease and heart failure.

How should we determine normal echocardiographic right ventricle function reference values in pediatrics?

Several models have been used to establish pediatric Z-scores for echocardiographic right ventricle (RV) variables. This study aimed to determine the most appropriate mathematical model for RV function reference values in pediatrics. Prospective cross-sectional study among 314 healthy children ages 2days to 18years (46% female, 88 infants, 26 neonates, 226 children). RV parameters (S', E', A' waves, TEI index, TAPSE) were modelized with four explanatory variables: age, height, weight and body surface area. Four mathematical models were applied: a linear model, a polynomial model of degree 2, a linear regression model by spline with free knot, and a polynomial regression model of degree 2 by spline with a free knot. The choice of the best method used the adjusted coefficient of determination (aR2). The modelization of RV variables did not follow a linear model. A single explanatory variable could not determine all Z-scores, as specific and independent variables were required for each parameter. The quadratic spline model best adjusted the modelization of RV variables. The S' wave was best modelized by the spline model with the weight (knot at 6.86kg). The E' wave was best modelized by the spline model with the age (knot at 0.29years). The A' wave was best modelized by the model with the height (knot at 81cm). The TAPSE was best modelized by the spline model with the weight (knot at 9.04kg). The spline regression models best applies to echocardiographic RV reference values in pediatrics.

Echocardiographic variables in healthy North American Salukis

IntroductionTo report normal echocardiographic variables from a population of healthy Salukis in North America. AnimalsThe study included 83 healthy adult Salukis from North America with structurally normal hearts. MethodsAll animals underwent a full physical examination and two-dimensional, M-mode, and Doppler echocardiography using the right parasternal and left apical views with the left ventricular volumes calculated using the Simpson's method of discs. Echocardiographic variables were compared among sex, body surface area, and body weight (BW) using linear regression. The 95% predictive intervals were calculated for both unadjusted and BW-adjusted data. ResultsNo relationship between sex and the echocardiographic variables was noted. Predictive intervals for echocardiographic variables are presented for 22 echocardiographic variables. Linear regression suggested that 16 of those variables were associated with BW. The 95% predictive intervals of echocardiographic variables adjusted for BW are reported. ConclusionsThe data from this study provide breed-specific echocardiographic reference values for Salukis.

P6479Right cavities dimensions: echocardiographic reference values and differences according to gender and anthropometric variables

P6479Right cavities dimensions: echocardiographic reference values and differences according to gender and anthropometric variables

Cardiac Valve Annulus Diameters in Extremely Preterm Infants: A Cross-Sectional Echocardiographic Study

Background: With the increasing incidence of births of very preterm very-low-birth-weight infants, there is a demand for echocardiographic reference values of cardiac dimensions. Objectives: The aim of this study was to provide reference values of cardiac valve annulus diameters in a cohort of extremely preterm very-low-birth-weight neonates and to correlate these with patient characteristics. Methods: Valve diameters of 376 infants of < 32 weeks’ gestation and with a birth weight of ≤2,000 g were measured using 2-dimensional echocardiography. Correlations between valve diameters and patient characteristics (birth length/weight, body surface area, gestational age, and sex) were assessed. Birth weight was used to establish linear regression models. Inter- and intraobserver agreement was assessed through intraclass correlation coefficient (ICC) analysis. Results: Substantial variability was found (aortic valve mean [standard deviation; range]: 5.0 mm [0.6; 3.7–6.5]; pulmonic valve: 5.8 mm [0.8; 3.4–7.9]; mitral valve: 8.0 mm [1.0; 5.5–10.5]; tricuspid valve: 7.6 mm [1.2; 4.9–10.6]). There was a moderate correlation between birth weight and valve diameter (R² aortic valve: 0.36; pulmonic valve: 0.20; mitral valve: 0.24; tricuspid valve: 0.24). Adequate intraobserver (ICC range 0.74–0.91) and interobserver agreement (ICC range 0.77–0.89) was found. Conclusions: Our study provides ready-to-use reference values for cardiac valve annulus diameters for extremely preterm infants.

Echocardiographic right ventricular function reference values in pediatrics: Which is the best mathematical model to define Z-scores?

Echocardiographic assessment of right ventricle (RV) function has become essential in pediatric cardiology. The aim of our study was to determine the most appropriate mathematical model for RV function reference values in children. Normal children aged 0 to 18 years referred to the pediatric cardiology consultation were screened in this prospective cross-sectional study. Each RV parameters (S’, E’, A’ waves, TEI index, TAPSE) was modeled with four explanatory variables: age, size, weight and body surface area. Four different mathematical models were applied: a linear model, a polynomial model of degree 2, a linear regression model by spline with free knot, and a polynomial regression model of degree 2 by spline with a free knot. The choice of the best explanatory variable and modelization method was made on the basis of the model's coefficient of determination ( R 2 ). We included 314 normal children aged 2 days to 18 years (46% female, 88 infants, 26 neonates, 226 children). The modelization of the RV variables over all ages did not follow a linear model, with the lowest coefficients of determination in the four explanatory variables. The quadratic spline model best adjusted the modelization of all RV variables. No model accurately explained the TEI index in any of the four explanatory variables. The S’ wave was best modelized by the quadratic spline model with the weight. The knot at 6.86 kg corresponded to the curves’ break. The E’ wave was best modelized by the quadratic spline model with the age. The knot at 0.29 years corresponded to the curve's break. The A’ wave was best modelized by the quadratic model with the size. The knot at 81 cm corresponded to the break of the curve. The TAPSE was best modelized by the quadratic spline model with the weight. The knot at 9.04 kg corresponded to the curve's break. The quadratic spline model best applies to echocardiographic RV reference values in pediatrics.

Reference Values for Physical Stress Echocardiography in Asymptomatic Patients after Mitral Valve Repair.

Clinical decision-making in symptomatic patients after mitral valve (MV) repair remains challenging as echocardiographic reference values are lacking. In native MV disease intervention is recommended for mean transmitral pressure gradient (TPG) >15 mmHg or systolic pulmonary artery pressure (SPAP) >60 mmHg at peak exercise. Insight into standard stress echo parameters after MV repair may therefore aid to clinical decision-making during follow-up. Stress echocardiography derived parameters in asymptomatic patients after successful MV repair differ from current guidelines for native valves. In 25 patients (NYHA I) after MV repair stress echocardiography was performed on a semi-supine bicycle. Doppler flow records and MV related hemodynamics at rest and peak were obtained. Linear regression analysis was performed for mean TPG and SPAP at peak, using predetermined variables and confounders. Mean TPG at rest (3.2 ± 1.4 mmHg) significantly increased at peak (15.0 ± 3.4 mmHg) but was always <25 mmHg. Mean SPAP at rest (21.4 ± 3.8 mmHg) significantly increased at peak (41.8 ± 8.9 mmHg) but was never >57 mmHg. Only the indexed MV ring diameter was inversely correlated to mean TPG at peak in a multivariable model. In contrast to current recommendations in native MV disease, our data indicate that the standard value for mean TPG during stress echocardiography in asymptomatic patients after successful MV repair was above the guideline threshold of 15 mmHg in >50%, but always <25 mmHg. For SPAP, patients never reached the guideline cutoff (60 mmHg). Long-term follow-up data are needed to provide insight in clinical consequences. Baseline stress echocardiography may indicate individual reference values to compare with during follow-up. https://clinicaltrials.gov/ct2/show/NCT02371863?term=chamuleau+AND+Mitral&rank=1.

Regression equations for calculation of z scores for echocardiographic measurements of left heart structures in healthy Han Chinese children.

Clinical decision making in children with heart disease relies on detailed measurements of cardiac structures using two-dimensional and M-mode echocardiography. However, no echocardiographic reference values are available for the Chinese children. We aimed to establish z-score regression equations for left heart structures in a population-based cohort of healthy Chinese Han children. Echocardiography was performed in 545 children with a normal heart. The dimensions of the aortic valve annulus (AVA), aortic sinuses of Valsalva (ASV), sinotubular junction (STJ), ascending aorta (AAO), left atrium (LA), mitral valve annulus (MVA), interventricular septal end-diastolic thickness (IVSd), interventricular septal end-systolic thickness (IVSs), left ventricular end-diastolic diameter (LVIDd), left ventricular end-systolic diameter (LVIDs), left ventricular posterior wall end-diastolic thickness (LVPWd), left ventricular posterior wall end-systolic thickness (LVPWs) were measured. Regression analyses were conducted to relate the measurements of left heart structures to body surface area (BSA). Left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were calculated. Several models were used, and the adjusted R2 values were compared for each model. AVA, ASV, STJ, AAO, LA, MVA, IVSd, IVSs, LVIDd, LVIDs, LVPWd, and LVPWs had a cubic relationship with BSA. LVEF and LVFS fell within a narrow range. Our results provide reference values for z scores and regression equations for left heart structures in Han Chinese children. These data may help make a quick and accurate judgment of the routine clinical measurement of left heart structures in children with heart disease.

Echocardiographic right ventricular function reference values in pediatrics: Which is the best mathematical model to define Z-Scores?

The aim of our study was to determine the most appropriate mathematical model for right ventricular (RV) function normal values in children. Normal children aged 0 to 18 years referred to the pediatric cardiology consultation were screened in this prospective cross-sectional study. Each RV parameters (S’, E’, A’ waves, TEI index, TAPSE) was modeled with four explanatory variables: age, size, weight and body surface area. Four different mathematical models were successively applied: a linear model, a polynomial model of degree 2, a linear regression model by spline with free knot, and a polynomial regression model of degree 2 by spline with a free knot. The choice of the best explanatory variable and the best modelization method was made on the basis of the model's coefficient of determination (R 2 ). We included 314 normal children aged 2 days to 18 years (46% female, 88 infants, 26 neonates, 226 children). The modelization of the RV variables over all ages did not follow a linear model, with the lowest coefficients of determination in the four explanatory variables. The quadratic spline model best adjusted the modelization of all RV variables. No model accurately explained the TEI index in any of the four explanatory variables. The S’ wave was best modelized by the quadratic spline model with the weight. The knot at 6.86 kg corresponded to the curves’ break. The E’ wave was best modelized by the quadratic spline model with the age. The knot at 0.29 years corresponded to the curve's break. The A’ wave was best modelized by the quadratic model with the size. The knot at 81 cm corresponded to the break of the curve. The TAPSE was best modelized by the quadratic spline model with the weight ( Fig. 1 ). The knot at 9.04 kg corresponded to the curve's break ( Fig. 1 ). The quadratic spline model best applies to echocardiographic RV reference values in pediatrics.

Normal Reference Ranges for Transthoracic Echocardiography Following Heart Transplantation

Heart function following heart transplantation (HTx) is influenced by numerous factors. It is typically evaluated using transthoracic echocardiography, but reference values are currently unavailable for this context. The primary aim of the present study was to derive echocardiographic reference values for chamber size and function, including cardiac mechanics, in clinically stable HTx patients. The study enrolled 124 healthy HTx patients examined prospectively. Patients underwent comprehensive two-dimensional echocardiographic examinations according to contemporary guidelines. Results were compared with recognized reference values for healthy subjects. Compared with guidelines, larger atrial dimensions were seen in HTx patients. Left ventricular (LV) diastolic volume was smaller, and LV wall thickness was increased. With respect to LV function, both ejection fraction (62±7%, P<.01) and global longitudinal strain (-16.5±3.3%, P<.0001) were lower. All measures of right ventricular (RV) size were greater than reference values (P<.0001), and all measures of RV function were reduced (tricuspid annular plane systolic excursion 15±4mm [P<.0001], RV systolic tissue Doppler velocity 10±6cm/sec [P<.0001], fractional area change 40±8% [P<.0001], and RV free wall strain -16.9±4.2% [P<.0001]). Ejection fraction and LV global longitudinal strain were significantly lower in patients with previous rejection. The findings of this study indicate that the distribution of routinely used echocardiographic measures differs between stable HTx patients and healthy subjects. In particular, markedly larger RV and atrial volumes and mild reductions in both LV and RV longitudinal strain were evident. The observed differences could be clinically relevant in the assessment of HTx patients, and specific reference values should be applied in this context.

Real-time three-dimensional echocardiographic left heart parameters in healthy indian adults

ObjectiveCardiac chamber dimensions are race and anthropometry dependent. We determined the age and gender specific 3-Dimensional echocardiographic (3DE) reference values for dimensions and function of left ventricle (LV) and left atrium (LA) in normal Indian adults. MethodsThis single center prospective study enrolled 133 adult Indians free of heart disease and/or hypertensions, subjecting them to 3DE measurements of left atrial (LA) & left ventricular (LV) volumes, function and left ventricular mass (LVM). The higher limits of normal cut-offs were determined for these parameters and their dependency on age, gender and anthropometry were analyzed. ResultsThe body surface area (BSA) corrected higher limit cut-offs were: 59.37ml/m2 for LV end diastolic volume (59.19ml/m2 and 59.61ml/m2 for men and women, respectively; P=NS); 23.48ml/m2 for LV end systolic volume (23.27ml/m2 and 23.11ml/m2 for men and women, P=NS). Mean LVEF was 64.79%±7.26 (62.99%±6.51 and 67.05%±7.58 in men and women, P=NS). Men had higher LVM than women (119.79g±23.95 vs. 103.26g±23.76, P<0.001), this difference disappeared after BSA indexing. The higher limit cut-offs for normal LA volumes were 20.49ml for minimum volume (21.18ml and 19.46ml for men and women, P=NS) and 39.76ml for maximum volume (39.60ml and 40.03ml in men and women, P=NS). The parameters were smaller compared to western populations but the differences attenuated after BSA indexing. ConclusionsThe study reports normal 3DE parameters of size and function of left heart chambers in Indians.

Reference values of two-dimensional and M-mode echocardiographic measurements as a function of body size in various equine breeds and in ponies

IntroductionThe aim of this study was to establish echocardiographic reference values for the equine species using allometric regression equations based on body weight (BW) and thoracic circumference (TC). AnimalsA total of 239 horses or ponies were studied, including 65 warmbloods, 33 Standardbreds, 41 Thoroughbreds, 32 Arabian horses, 28 draft horses, and 40 ponies aged from 1 day to 30 years, weighing from 18 to 890 kg, with no evidence of cardiac disease. MethodsFor each horse or pony, a two-dimensional and M-mode echocardiography was performed. Within each breed, the relationships between BW or TC and echocardiographic dimensions were examined using power regression equations. Predictions and their 95% prediction intervals were calculated for the echocardiographic measurements. ResultsWithin each breed, all echocardiographic measurements showed a significant and positive relationship with a high coefficient of determination for the estimation of the regression equations using BW and TC as the main explanatory variables. Breed-specific power regression equations as well as the 95% prediction intervals were calculated for each echocardiographic measurement as a function of BW and TC. ConclusionsIn the future, the body size-corrected and breed-specific echocardiographic reference values calculated in the present study could be used to discriminate between normal and abnormal values in a given animal.

Echocardiographic Reference Values of the Pulmonary Artery Acceleration Time in 756 Healthy Children and Impact on Pediatric Pulmonary Hypertension

Echocardiographic Reference Values of the Pulmonary Artery Acceleration Time in 756 Healthy Children and Impact on Pediatric Pulmonary Hypertension

M-mode echocardiographic reference values in Pantja goats.

Aim:The aim of this study was to establish M-mode echocardiographic reference values in Pantja goats and to study the effect of gender and body weight (BW) on these parameters.Materials and Methods:A total of 18, clinically healthy, adult Pantja goats of either sex, aged 2-4 years and weighing 10-44 kg were included in the study. Echocardiographic examination was performed in the standing unsedated animal. All measurements were made from the right parasternal long-axis left ventricular outflow tract view of the heart. The following parameters were recorded: Left ventricular internal diameter at diastole and systole, interventricular septal thickness at diastole and systole, left ventricular posterior wall (LVPW) thickness at diastole and systole, end diastolic and systolic volumes, stroke volume, fractional shortening, ejection fraction, percent systolic thickening of interventricular septum, percent systolic thickening of LVPW, cardiac output, left atrial (LA) diameter at diastole and systole, aortic (AO) root diameter at diastole and systole, LA/AO, LA posterior wall thickness at diastole and systole, left ventricular ejection time, DE amplitude, EF slope, AC interval and e-point to septal separation.Results:This study demonstrated specific reference ranges of M-mode echocardiographic parameters and indices in healthy Pantja goats. Normal echocardiographic values obtained in Pantja goats were quite different from other goat breeds. Gender had no influence on echocardiographic parameters, while high correlations were found between most echocardiographic parameters and BW.Conclusion:The echocardiographic values obtained in the study may serve as a reference for future studies in this breed, for cardiovascular disease diagnosis and for utilizing the goat as a model for cardiac disorders in humans.

Índices e dimensões ecocardiográficas de equinos da raça Mangalarga Marchador

Resumo: Com o objetivo de determinar os valores de referência ecocardiográficos de equinos da raça Mangalarga Marchador, foram avaliados 80 equinos desta raça, machos e fêmeas, com 1,6 a 16 anos de idade, pesando entre 320 a 500 kg, divididos igualmente em 4 grupos: fêmeas de 1,6 a 4 anos de idade (G1), fêmeas com mais de 4 anos de idade (G2), machos de 1,6 a 4 anos de idade (G3), machos com mais de 4 anos de idade (G4). A avaliação constou de exame ecocardiográfico mono e bidimensional, tendo sido realizados através da janela cardíaca direita, nos modos B e M: DIVDs, DIVDd, SIVs, SIVd, DIVEs, DIVEd, PLVEs, PLVEd, Aod, FS%, EF%, AEs, Aod, Aes/ Aod, ponto E-S. Através da janela cardíaca esquerda nos modos B e M: DIVEs, DIVEd, FS%, EF%, AEs. Foram observadas diferenças estatísticas entre as médias dos quatro grupos dos seguintes parâmetros: Aod, AEs, DIVDs, DIVDd, SIVs, SIVd, DIVEs, DIVEd, PLVEs, PLVEd, Vs, Vd e correlações estatísticas positivas entre Aod, AEs, SIVs, SIVd, PLVEs, PLVEd, Vd e a idade, entreAod, AEs, SIVs, SIVd, DIVEd, PLVEs, AEs/Aod e o peso e o perímetro torácico e entre Aod, AEs, SIVs, SIVd, DIVEs, PLVEs, Vd e a altura da cernelha. Houve influência tanto do sexo como da faixa etária sobre os valores de referência para equinos da raça Mangalarga Marchador, tendo os machos acima de 4 anos apresentados valores de medidas ventriculares maiores. O peso, altura e idade dos animais influenciaram da mesma forma os resultados, estando todos relacionados positivamente ao tamanho da estrutura cardíaca.

Normal reference values of echocardiographic measurements in young Egyptian adults

Abstract Background Normal values for echocardiographic measurements are widely based on cohorts from North American populations. Differences have been shown to exist that could be attributed to racial and ethnic differences. Objective To define the normal echocardiographic reference values for various cardiac measurements in young, healthy Egyptian adults. Methods This study was performed on 1,364 healthy adults aged 18–35 years. Standard trans-thoracic echocardiographic studies were performed to obtain end diastole measurements of left ventricular (LV) posterior wall thickness (PWd), interventricular septum thickness (IVSd), LV internal dimensions at end diastole (LVEDD) and end systole (LVESD), left atrial (LA) diameter, aortic root diameter and right ventricular outflow dimension (RVd). LV ejection fraction (LVEF), LV mass and relative wall thickness were assessed. All measurements were then indexed to body surface area (BSA). Based on our results we proposed normal reference values for young Egyptian adults. Results On comparing subjects according to gender, absolute measurements showed males had significantly larger LVEDD, LVESD, IVSd, PWd, LV mass, LA anteroposterior diameter and aortic root diameter ( p p = 0.008). There was no difference regarding RVd ( p = 0.118). Females had larger indexed LVEDD ( p = 0.0003), indexed LA and aortic root diameters ( p = 0.0005 and 0.007 respectively) and indexed RVd ( p 2 ( p Conclusions Estimation of local reference values is important to define normalcy. The main difference from international values was a higher upper reference limit for LV mass especially in females and relatively smaller LA dimensions in young Egyptians.

Normal Reference Values for Doppler Echocardiography: Influences of Ageing, Gender and Ethnicity.

Normal Reference Values for Doppler Echocardiography: Influences of Ageing, Gender and Ethnicity.

Doppler Echocardiographic Measurements in Normal Chinese Adults (EMINCA): a prospective, nationwide, and multicentre study

Currently, available Doppler echocardiographic reference values are derived mainly from North American and European population studies, which may not applicable to the Chinese population. We aimed to establish normal reference values of Doppler echocardiographic parameters in a nationwide, population-based cohort of healthy Han Chinese adults. A total of 1394 qualified healthy subjects (mean age 47.3 ± 16.0 years, 678 men) were enrolled at 43 collaborating laboratories, 37 transvalvular flow and tissue Doppler parameters were obtained, and the impacts of gender and age on each parameter were analysed. Significant differences were found between men and women in 48.6% (18/37) of the parameters analysed, and among different age groups in 83.8% (31/37) of the parameters in men and in 86.5% (32/37) of the parameters in women. Normal reference values of Doppler echocardiographic parameters were established for the first time in a nationwide, population-based cohort of healthy Han Chinese adults. Since most of these parameters differed by gender and/or age, reference values specified for gender and age should be recommended in clinical practice.

Echocardiographic Reference Values for Right Atrial Size in Children with and without Atrial Septal Defects or Pulmonary Hypertension.

Right atrial (RA) size may become a very useful, easily obtainable, echocardiographic variable in patients with congenital heart disease (CHD) with right-heart dysfunction; however, according studies in children are lacking. We investigated growth-related changes of RA dimensions in healthy children. Moreover, we determined the predictive value of RA variables in both children with secundum atrial septal defect (ASD) and children with pulmonary hypertension (PH) secondary to CHD (PH-CHD). This is a prospective study in 516 healthy children, in 80 children with a secundum ASD (>7 mm superior-inferior dimension), and in 42 children with PH-CHD. We determined three RA variables, i.e., end-systolic major-axis length, end-systolic minor-axis length, and end-systolic area, stratified by age, body weight, length, and surface area. RA end-systolic length and area z scores were increased in children with ASD and PH-CHD when compared to those variables in the healthy control population. Using the Youden Index to determine the best cutoff scores in sex- and age-specific RA dimensions, we observed a sensitivity and specificity up to 94 and 91 %, respectively, in ASD children and 98 and 94 %, respectively, in PH-CHD children. We provide normal values (z scores -2 to +2) for RA size and area in a representative, large pediatric cohort. Enlarged RA variables with scores >+2 were predictive of secundum ASD and PH-CHD. Two-dimensional determination of RA size can identify enlarged RAs in the setting of high volume load (ASD) or pressure load (PH-CHD).

Echocardiographic and Blood Pressure Characteristics of First-Year Collegiate American-Style Football Players

Echocardiographic (echo) and blood pressure (BP) reference values may help identify athletes at cardiovascular risk, yet benchmarks are inadequate for collegiate American-style football (ASF) players. Our purpose was to describe echo characteristics and BP values in collegiate ASF athletes compared with normal. First-year players (n = 80, age = 18 ± 1 years, height = 186 ± 7 cm, weight = 100.1 ± 22.0 kg, body mass index = 28.7 ± 5.0), body surface area [BSA] = 2.24 ± 0.25; percentage fat = 16.5 ± 9.7%) were measured for systolic and diastolic BP, and underwent echo procedures by a certified sonographer. Data analyses included simple statistics, Pearson r, frequencies in normal ranges, and t test; α = 0.05. Selected echo measurements (and indexed by BSA) were: left ventricular (LV) internal diameter diastole = 5.3 ± 0.5 cm (2.4 ± 0.3); left atrial diameter = 3.9 ± 0.5 cm (1.8 ± 0.2): LV end-diastolic volume = 138 ± 30 ml (62 ± 11); septal wall thickness = 1.0 ± 0.2 cm (0.5 ± 0.1); LV posterior wall thickness = 1.0 ± 0.1 cm (0.5 ± 0.1), LV mass = 212 ± 46 g (95 ± 18); and relative wall thickness = 0.39 ± 0.07. Correlations between BSA and echo variables were significant (r = 0.26 to 0.50). Indexing by BSA reduced percentages above reference ranges from 36% to 7%. Septal wall thickness index was significantly greater in black (0.5 ± 0.1) than nonblack (0.4 ± 0.1) athletes. Fifty-nine athletes were hypertensive or prehypertensive, and diastolic BP was significantly greater in black (76 ± 10 mm Hg) compared with nonblack athletes (71 ± 8 mm Hg). ASF athletes demonstrated LV wall thicknesses and cavity sizes consistent with sport-training hypertrophy but which were unremarkable when indexed by BSA. Ethnicity generally did not influence echo variables. No ASF players were identified with cardiac dysfunction or disease.