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01.12.2019 | Research | Ausgabe 1/2019 Open Access

Cardiovascular Ultrasound 1/2019

Normative reference ranges for echocardiographic chamber dimensions in a healthy Central European population: results from the Czech post-MONICA survey

Cardiovascular Ultrasound > Ausgabe 1/2019
Josef Marek, Jean-Claude Lubanda, Renata Cifkova, Petr Kuchynka, Lubor Golan, Eduard Nemcek, Ales Linhart
Wichtige Hinweise

Supplementary information

Supplementary information accompanies this paper at https://​doi.​org/​10.​1186/​s12947-019-0172-0.

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Normative reference values for echocardiographic chamber quantification are of great importance; however, this can be challenging. Our aim was to derive these values including degrees of abnormality from a random Central European population sample with a homogeneous subset of healthy subjects.


We analysed echocardiograms obtained in a randomly selected population sample during the Czech post-MONICA survey in 2007/2008. Overall, 1850 out of 2273 persons of the whole sample of three districts had adequate echocardiograms (81.4%). A healthy subgroup defined by the absence of known cardiovascular disease was used to define normal reference range limits (n = 575, median age 42 years [IQR 34–52], 57% females). The whole population sample with predefined percentile cut-offs was used to define degrees of abnormality.


Left ventricular (LV) size tended to decrease with age, while LV mass increased with age in both males and females and in both the healthy and general populations. LV dimensions were larger in males, except for body surface area-indexed LV diameter. M-mode derived LV measurements were larger and LV mass higher compared to 2D measurements. Right ventricle basal dimension was larger in males.


Our study provides reference ranges for echocardiographic measurements obtained in a healthy subgroup derived from an epidemiological study of a Central European population. Where feasible, degrees of abnormality are provided based on the whole population sample including patients with disease. Our data show that age, gender and measurement method significantly affect cardiac dimensions and function and should be always taken into account.
Additional file 1: Figure S1. Shows distribution of LV mass (both using M-mode and 2D imaging) and indexed LA volume distribution in both healthy and general cohort. It can be seen that distributions of most variables are significantly skewed. Furthermore, reference limits based on 95th percentile of normal population and 97.5th and 99th percentile of general populations are shown with points and annotated with values. Horizontal axis has been truncated at 150% of the 99th percentile of general population. Gaussian kernel density estimates are used for plotting. BSA, body surface area; LV, left ventricle. Figure S2. Showing distribution of indexed LV mass using different measurement methods by age and gender. Reference limits based on gender and age derived from quantile regression are shown. Severe abnormality is above 99th percentile of general population, moderate 97.5th – 99th percentile of general population and mild between 95th percentile of the healthy population and 97.5th percentile of general population. One female outlier from general population with LV mass over 250 g was excluded from the plotting but is included in the analyses. BSA, body surface area; LV, left ventricle. Table S1. Female reference limits by age - left ventricle. Table S2. Female reference limits by age – atria and aortic root. Table S3. Male reference limits by age – left ventricle. Table S4. Male reference limits by age – atria and aortic root. Table S5. Echocardiographic parameters for healthy population – left ventricle. Table S6. Echocardiographic parameters for healthy population – left atrium, right chambers and aorta.
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