Age- and Sex-Specific Reference Values for Atrial and Ventricular Structures in the Validated Normal Chinese Population: A Comprehensive Measurement by Cardiac MRI

Abstract

Background: Left and right cardiac structures have been shown to provide important prognostic information in patients with various cardiac disorders. They have always been important biomarkers in patients with heart failure and are crucial in the judgment of a variety of heart diseases.

Purpose: To provide age- and sex-specific reference values of the normal cardiac structure of Chinese adults.

Study type: Prospective study.

Population: In all, 200 healthy adult volunteers with 20 men and 20 women in each of five age deciles from 20 to 70 years.

Field strength: 3.0T, steady-state free precession (SSFP), turbo spin-echo (TSE) sequence.

Assessment: The reference range of cardiac structure values was normalized to age, gender, and body surface area (BSA). The height, weight, blood pressure, and body mass index were measured as well.

Statistic tests: Kolmogorov-Smirnov's, independent-sample t-tests, one-way analysis of variance (ANOVA), Pearson's coefficient, and linear regression.

Results: The normalized left atrial (LA) transverse diameter (two-chamber view) at end-systolic, and left ventricular outflow tract diameter (LVOT) were significantly larger in females compared to males (all P < 0.001), while LA volume at end-systole was found higher in males (males: 36.25 ± 10.03 mL vs. females: 32.78 ± 10.27 mL). With increasing age, there was a weak but significant decrease in normalized LA transverse diameter (two-chamber view) at end- systolic (r = -0.25, P < 0.001). The normalized RA volume at end-systole and RVOT diameter showed significant decrease with advancing age (r = -0.22, P = 0.002; r = -0.34, P < 0.001). The indexed left and right ventricular volumes were mostly smaller with advancing age. The LA longitudinal parameters correlated significantly with LA area measured in the two-chamber view at end-systole (r = 0.78, P < 0.001).

Data conclusion: Reference values for the morphological parameters of the intracardiac structure by sex and age distribution are provided in a Chinese population.

Level of evidence: 2 TECHNICAL EFFICACY: Stage 5 J. Magn. Reson. Imaging 2020;52:1031-1043.

Keywords: aging; atrial; magnetic resonance imaging; reference values; sex; ventricle.