Comparison Study Of Echocardiographic Reference Values Between Chinese Han Adult’s And Recommendations By American Society Of Echocardiography

Objective: To analyze the normal value difference of echocardiographic measurement between those of Chinese Han adults and the reference values recommended by American Society of Echocardiography guideline for quantitative analysis of chamber size and ventricular function,and to demonstrate the normal value difference of cardiac structure and function between Chinese Han adults and American populations.Methods: A number of echocardiographic reference values from Echocardiographic Measurements in Normal Chinese Adults(EMINCA)study was selected to be compared with the same normal reference values recommended by American Society of Echocardiography guideline.The ASE reference values were used to be the test value to carry out a one sample t-test on the EMINCA reference values.To analyze the differences of internal diameter,volume,mass and function parameters of the left and right ventricles and the parameters of the aortic internal diameter between these two populations,the comparison of the measurements stratified by age and gender was performed.Results: 1.The comparison of general 2-D LV parameters: Compared with ASE guideline reference values,the LVD,LVV,LVM of Chinese Han males were lower,and the IVSd,LVPWd of Chinese Han males were higher with statistical significance(P<0.05).The LVESD,LVV,LVEF,LVD/BSA of Chinese Han females were lower than that of ASE guideline,and the IVSd,LVPWd of Chinese Han females were higher with statistical significance(P<0.05).While there were no significant differences in the LVESD,LVM,LVEDV/BSA,LVESV/BSA,LVM/BSA of Chinese Han females in comparison with ASE guideline reference values.2.The comparison of LV parameters stratified by age: Compared with ASE guideline reference values,the LVV,LVV/BSA of Chinese Han males in all age groups were lower,and the LVEF of Chinese Han males age more than 30 was higher with statistical significance(P<0.05).In females age less than 40,the LVV,LVV/BSA of Chinese Han females were lower than that of ASE guideline,and the LVEF of Chinese Han females was higher with statistical significance(P<0.05).While there were significant differences in LVV,LVEF of Chinese Han females age more than 40 in comparison with ASE guideline reference values.The LVV/BSA of Chinese Han females age between 40 to 59 was higher with no statistical significance(P>0.05).The LVV/BSA of Chinese Han females age more 60 was higher with statistical significance(P<0.05).3.The comparison between LV values in EMINCA study and the normal ranges recommended by the ASE: In the copmarasion of all left ventricular values,more than 5% people in EMINCA study were not in normal group recommended by ASE guidline,and even more than 10% in some values comparasion.4.The comparison of general 2-D LA parameters: Compared with ASE guideline reference values,the LA-ap,LA-ap/BSA,LAA/BSA,LAV/BSA of Chinese Han adults were lower with statistical significance(P<0.05).5.The comparison of general 2-D RV parameters: The RV-l,RV-m,RV-b,RVOT of Chinese Han adults were lower than that of ASE guideline with statistical significance(P<0.05).6.The comparison of general 2-D RA parameters: Compared with ASE guideline reference values,the RA-l/BSA,RA-t/BSA of Chinese Han adults were higher with statistical significance(P<0.05).7.The comparison of general 2-D Aorta parameters: Compared with ASE guideline reference values,the AO-a,AO-s,AO-asc of Chinese Han adults were lower with statistical significance(P<0.05).The AO-a /BSA of Chinese Han adults was lower than that of ASE guideline,while the AO-asc /BSA of Chinese Han adults was higher with statistical significance(P<0.05).8.The comparison of LV Doppler parameters stratified by age: Compared with ASE guideline reference values,the DT,e′,e′/a′ of Chinese Han adults age less than 20 were with no statistical significance(P>0.05),while there was significant difference in people age more than 20(P<0.05).There was significant difference of IVRT,DT,A-d in Chinese Han adults age less than 60 in comparison with ASE guideline(P<0.05),while there was no statistical significance when people age more than 60(P>0.05).With aging,the IVRT,DT,A-d of Chinese Han adults tend to increase,and the differences between two populations tend to decrease.The E/A,e′-s,e′-l,e′/a′-s,e′/a′-l of Chinese Han adults tend to decrease with age,while the differences between two populations tend to increase.9.The comparison of measurements of doppler RV parameters: Compared with ASE guideline reference values,the E/A-tv,e′-tv of Chinese Han adults were lower,and the e′/a′-tv,E/e′-tv of Chinese Han adults were higher with statistical significance(P<0.05).Conclusions: There are substantial differences between Chinese population and American population.Using the normal measurement values recommended by the ASE guideline to define the normal Chinese Han adults,the probability of false positive or false negative would increase.With aging,the change regularities of echocardiographic measurements among different populations are different.Body surface area standardization may partly reduce the difference between two populations.But the difference can not be vanished,and the role of BSA may even be exaggerated sometimes.The differences between different populations are caused by many factors.Single factor can not be used to correct interpretation.The differences are racial differences.