Background

Gender and racial differences in cardiac chamber size are vital to establish normal ranges of cardiac chamber size in healthy subjects. Many studies report either nonindexed raw measurements or measurements indexed to isometric body surface area (BSA) when establishing normal reference values. Other studies advocate allometric indexation for standardization of heart size. We compared several allometric methods on gender and racial differences in left ventricular end-diastolic volume (LVEDV) measured on three-dimensional echocardiography.

Methods

Three-dimensional echocardiographic LVEDV data from the World Alliance Societies of Echocardiography normal values study were indexed to isometric BSA, BSA^1.5, BSA^1.8, isometric height, height^2.3, height^2.9, and estimated lean body mass. Gender, racial, national, and regional differences in indexed and nonindexed LVEDV were assessed using Cohen’s d statistic or Cohen’s f statistic, according to the number of groups being compared. Cohen’s d < 0.20 and Cohen’s f < 0.10 were regarded as very small relative magnitudes of difference.

Results

Differences in LVEDV among White, Black, and Asian races were smallest when BSA^1.5 or BSA^1.8 was used for indexation, followed by estimated lean body mass. LVEDV/BSA^1.5 was nearly identical for men and women (very small, d = 0.05). However, both LVEDV/BSA^1.5 and LVEDV/BSA^1.8 still provided moderate relative magnitudes of difference (f = 0.22–0.37) among geographic regions. Specifically, among Asians, Indians had the smallest LVEDV/BSA^{1.5 (1.8)}. Brazilians had the smallest LVEDV/BSA^{1.5 (1.8)} among Whites.

Conclusions

Gender and racial differences in LVEDV became smaller when LVEDV was indexed to BSA^1.5 or BSA^1.8. However, differences in LVEDV among nations remain even after applying allometric scaling. This finding suggests that differences in body composition and/or hemodynamics are potentially more important determinants of heart size than race or gender.

中文翻译：

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左心室舒张末期容积指数化异速生长法在正常超声心动图数据和评估性别和种族差异中的应用

背景

心腔大小的性别和种族差异对于确定健康受试者心腔大小的正常范围至关重要。许多研究在建立正常参考值时报告非索引原始测量值或索引到等距体表面积 (BSA) 的测量值。其他研究提倡用异速生长指数来标准化心脏大小。我们比较了在三维超声心动图上测量的左心室舒张末期容积 (LVEDV) 的性别和种族差异的几种异速生长方法。

方法

来自世界超声心动图学会联盟正常值研究的三维超声心动图 LVEDV 数据与等长 BSA、BSA ^1.5、BSA ^1.8、等长身高、身高^2.3、身高^2.9和估计的去脂体重相关联。根据被比较的组数，使用 Cohen's d统计量或 Cohen's f统计量评估索引和非索引 L​​VEDV 的性别、种族、国家和地区差异。Cohen's d  < 0.20 和 Cohen's f  < 0.10 被认为是非常小的相对差异幅度。

结果

^{当 BSA 1.5}或 BSA ^1.8用于指数化时，白人、黑人和亚洲人种之间 LVEDV 的差异最小，其次是估计的去脂体重。男性和女性的LVEDV/BSA ^1.5几乎相同（非常小，d  = 0.05）。然而，LVEDV/BSA ^1.5和 LVEDV/BSA ^1.8仍然在地理区域之间提供了适度的相对差异幅度 ( f  = 0.22–0.37)。具体而言，在亚洲人中，印度人的 LVEDV/BSA 最小，为^{1.5 (1.8)}。^{巴西人的 LVEDV/BSA 1.5 (1.8)}在白人中最低。

结论

当 LVEDV 被索引到 BSA ^1.5或 BSA ^{1.8时，LVEDV 的性别和种族差异变得更小}。然而，即使在应用异速生长缩放后，各国之间 LVEDV 的差异仍然存在。这一发现表明，身体成分和/或血液动力学的差异可能是比种族或性别更重要的心脏大小决定因素。