Age- and Gender-Dependency of Left Ventricular Geometry Assessed with Real-Time Three-Dimensional Transthoracic Echocardiography

AbstractBackgroundDifferences have shown to exist in some echocardiographic measurements that were attributed to racial, ethnic and gender. This study determined echocardiographic baseline data of normal adult left ventricular (LV) geometry in our locality.MethodsThe study was performed on 1,192 apparently healthy adults. Participants below the age of 18 years or those with congenital or acquired cardiac abnormalities and history of long-term regular physical training were excluded. Trans-thoracic echocardiography was performed with Vivid T8 GE dedicated echocardiography machine with probe frequency of 1.7 to 3.2 MHz with integrated electrocardiography (ECG) recording electrodes. The study determined normal dimensions of interventricular diamensions. All measurements were indexed to body surface area (BSA) to obtain echocardiographic baseline normal reference values.ResultsThe mean + SD values of LV parameters for male and female participants were: LVIDd (44.80 ± 5.71 mm vs 42.75 ± 5.21 mm), LVIDs (33.54 ± 5.37 mm vs 30.38 ± 4.81 mm), and LVPWd (8.32 ± 1.26 mm vs 7.51 ± 1.22 mm). Females had more statistically significant interventricular septum in diastole (IVSd) (8.20 ± 1.38 mm vs 7.05 ± 1.27 mm) and interventricular septum in systole (IVSs) (9.08 ± 1.42 mm vs 8.99 ± 1.33 mm) (P < 0.05).ConclusionThis research established echocardiographic baseline normal adult left ventricular geometry in the study population because in order to detect abnormalities, accurate definition of normal values of echocardiographic measurements is of utmost importance for a reliable clinical decision making.

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Reliability of Cardiac Percussion Technique to Determine Left Ventricular Geometry in Comparison with Transthoracic Echocardiography

Medical & Clinical Research ◽

10.33140/mcr.06.05.10 ◽

2021 ◽

Vol 6 (5) ◽

Keyword(s):

Transthoracic Echocardiography ◽

Left Ventricular ◽

Left Ventricular Geometry ◽

Cardiothoracic Ratio ◽

Ventricular Geometry ◽

Two Measures ◽

Lv Volumes ◽

Bedside Method ◽

Chamber Size

Background: Cardiac percussion (CP) is a bedside technique to evaluate cardiac borders and chamber size. Although advanced cardiac imaging has revolutionized the methods to detect cardiomegaly, art of CP remains the most convenient option, especially in emergent situations. Although transthoracic echocardiography (TTE) is considered the gold standard to determine left ventricular (LV) size, CP can estimate LV size with equal accuracy as TTE in appropriate clinical setting. The aim of this study was to investigate the correlation of LV size assessed by CP technique versus standard TTE, as well as cardiothoracic ratio (CTR) on chest roentgenography (CXR). Methods: This descriptive study was conducted on Telemetry units. Patients were positioned in supine position at Gatch angle of 30-45 degrees. Cardiac dullness was measured in cm by percussing from mid clavicular line towards gladiolus of sternal body. Subsequently, findings were correlated with TTE dimensions of left ventricular end-diastolic diameter (LVEDD). Results: In 200 patients, mean age was 63+15.8 years, with 51% females. The LV diameter (LVD) measured by CP technique was observed to be similar to LVEDD measured by TTE (Mean- 4.65+0.67 cm versus 4.69+0.76 cm, COV 7.6%). The BlandAltman comparison of CP technique and TTE measurements indicated significant differences in variances between the two measures (r=0.270, p=<0.001). The LVD measured by CXR did not show correlation with LVEDD (5.79+1.21 cm, COV 14.3%) with significant differences in the variances between the two measures (r=-0.475, p<0.001). The LV volumes measured by CP technique were observed to have correlation with LV volumes measured by TTE (COV 14.9%). Conclusion: CP technique is a convenient bedside method that can be utilized to assess LVD and volume. It is shown to have a precise correlation with LVEDD measured by TTE. The study emphasizes role of bedside estimation of LV size by using the art of physical examination.

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