- Oral presentation
- Open Access
Derivation of consolidated normal reference values for right and left ventricular quantification by cardiac magnetic resonance using a novel meta-analytic approach
© Zhan et al. 2016
- Published: 27 January 2016
- Cardiac Magnetic Resonance
- Left Ventricular Mass
- Papillary Muscle
- Left Ventricular Mass Index
- Trained Athlete
Although cardiac magnetic resonance (CMR) has superior accuracy and reproducibility for quantification of ventricular size and function, its interpretation is limited by non-robust normative data derived mainly from small single-center studies.
We performed a systematic review of the literature from 2003-2015 to identify all published studies that measured right and left ventricular parameters by CMR in healthy adult controls. The parameters of interest were: end-diastolic volume, end-systolic volume, stroke volume, ejection fraction, and mass (indexed to body surface area). Inclusion criteria were: SSFP-based acquisition and quantification on a short-axis stack using the method of discs. Exclusion criteria were: enrollment of non-healthy subjects, trained athletes, or overlapping data with other publications. Queries related to overlapping data were resolved by contacting the authors of the studies. We extracted age- and sex-specific data when available and stratified according to whether the papillary muscles were traced or not. We also accounted for the distribution of each parameter (rather than assuming a normal distribution), which was determined from a subset of individual patient-level data. Two observers reviewed the studies in duplicate and a third observer audited discordances. We performed a random-effects meta-analysis of the data (using the same approach developed for the American Society of Echocardiography chamber quantification guidelines) to generate pooled mean values for each parameter, upper reference values, lower reference values, and 95% confidence intervals surrounding each of these values.
Normal Reference Values for Right and Left Ventricular Parameters by CMR
The consolidated reference values generated by our meta-analytic approach have provided robust estimates of upper and lower limits of normal that reflect the accumulated body of published data for right and left ventricular quantification using SSFP-based CMR.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.