Background

Assessment of cardiac output (CO) and stroke volume (SV) is essential to understand cardiac function and hemodynamics. These parameters can be examined using three echocardiographic techniques (pulsed-wave Doppler, two-dimensional [2D], and three-dimensional [3D]). Whether these methods can be used interchangeably is unclear. The influence of age, sex, and ethnicity on CO and SV has also not been examined in depth. In this report from the World Alliance of Societies of Echocardiography Normal Values Study, the authors compare CO and SV in healthy adults according to age, sex, ethnicity, and measurement techniques.

Methods

A total of 1,450 adult subjects (53% men) free of heart, lung, and kidney disease were prospectively enrolled in 15 countries, with even distributions among age groups and sex. Subjects were divided into three age groups (young, 18–40 years; middle aged, 41–65 years; and old, >65 years) and three main racial groups (whites, blacks, and Asians). CO and SV were indexed (cardiac index [CI] and SV index [SVI], respectively) to body surface area and height and measured using three echocardiographic methods: Doppler, 2D, and 3D. Images were analyzed at two core laboratories (one each for 2D and 3D).

Results

CI and SVI were significantly lower by 2D compared with both Doppler and 3D methods in both sexes. SVI was significantly lower in women than men by all three methods, while CI differed only by 2D. SVI decreased with aging by all three techniques, whereas CI declined only with 2D and 3D. CO and SV were smallest in Asians and largest in whites, and the differences persisted after normalization for body surface area.

Conclusions

The present results provide normal reference values for CO and SV, which differ by age, sex, and race. Furthermore, CI and SVI measurements by the different echocardiographic techniques are not interchangeable. All these factors need to be taken into account when evaluating cardiac function and hemodynamics in individual patients.

中文翻译：

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根据测量技术、年龄、性别和种族的心输出量和每搏输出量的正常值：世界超声心动图学会联盟的结果

背景

心输出量 (CO) 和每搏输出量 (SV) 的评估对于了解心脏功能和血流动力学至关重要。这些参数可以使用三种超声心动图技术（脉冲多普勒、二维 [2D] 和三维 [3D]）进行检查。这些方法是否可以互换使用尚不清楚。年龄、性别和种族对 CO 和 SV 的影响也尚未得到深入研究。在世界超声心动图正常值研究学会联盟的这份报告中，作者根据年龄、性别、种族和测量技术比较了健康成年人的 CO 和 SV。

方法

前瞻性招募了来自 15 个国家的 1,450 名没有心脏、肺和肾脏疾病的成年受试者（53% 为男性），年龄组和性别之间分布均匀。受试者被分为三个年龄组（年轻，18-40 岁；中年，41-65 岁；老年，>65 岁）和三个主要种族组（白人、黑人和亚洲人）。CO 和 SV 以体表面积和身高为索引（分别为心脏指数 [CI] 和 SV 指数 [SVI]），并使用三种超声心动图方法进行测量：多普勒、2D 和 3D。图像在两个核心实验室进行分析（2D 和 3D 各一个）。

结果

与多普勒和 3D 方法相比，2D 方法在男女中的 CI 和 SVI 均显着降低。通过所有三种方法，女性的 SVI 均显着低于男性，而 CI 仅存在 2D 差异。所有三种技术的 SVI 都会随着年龄的增长而下降，而 CI 仅随着 2D 和 3D 的变化而下降。CO 和 SV 在亚洲人中最小，在白人中最大，并且在体表面积标准化后，差异仍然存在。

结论

目前的结果提供了 CO 和 SV 的正常参考值，该值因年龄、性别和种族而异。此外，不同超声心动图技术的 CI 和 SVI 测量结果不可互换。在评估个体患者的心功能和血流动力学时，需要考虑所有这些因素。