A meta-Analysis of echocardiographic measurements of the left heart for the development of normative reference ranges in a large international cohort: The EchoNoRMAL study
Poppe KK., Anderson T., Dyck J., Ezekowitz JA., Chirinos JA., De Buyzere ML., Gillebert TC., Rietzschel E., Segers P., Van Daele CM., Doughty RN., Walsh HA., Whalley GA., Izzo R., De Luca N., Trimarco B., De Simone G., Chen P-C., Chien K-L., Lin H-J., Su T-C., Mogelvang R., Jensen JS., Chadha DS., Goel K., Misra A., Detrano R., Cameron V., Richards AM., Troughton R., Di Pasquale P., Paterna S., Duzenli MA., Hobbs FDR., Davies MK., Davis RC., Roalfe A., Calvert M., Freemantle N., Gill PS., Lip GYH., Kuznetsova T., Staessen JA., Dargie HJ., Ford I., McDonagh TA., McMurray JJV., Grossman E., Galasko G., Lahiri A., Senior R., Blauwet L., Sliwa K., Stewart S., Brown A., Carrington M., Krum H., McGrady M., Zeitz C., Dalen H., Hansen HEM., Støylen A., Thorstensen A., Daimon M., Watanabe H., Yoshikawa J., Fukuda S., Kim H-K., Leung NKW., Linhart A., Chahal N., Chambers JC., Kooner J., Davies J., Loke I., Ng L., Squire IB., Aune E., Otterstad JE., Leung DY., Ng ACT., Ojji D., Arnold L., Coffey S., D'Arcy J., Hammond C., Mabbett C., Lima C., Loudon M., Pinheiro N., Prendergast B., Reynolds R., Badano LP., Muraru D., Peluso D., Dal Bianco L., Petrovic DJ., Petrovic J., Schvartzman P., Fuchs FD., Katova T., Simova I., Kaku K., Takeuchi M., Boyd A., Thomas L., Chia EM., Schirmer H., Angelo LC., Pereira AC., Krieger JE., Mill JG., Rodrigues SL., Muiesan ML., Paini A., Rosei EA., Salvetti M., Gardin JM., Nagueh SF., Altman D., Perera R., Triggs CM., Au Yeung H., Beans Picon GA.
Aim: To develop age-, sex-, and ethnic-Appropriate normative reference ranges for standard echocardiographic measurements of the left heart by combining echocardiographic measurements obtained from adult volunteers without clinical cardiovascular disease or significant cardiovascular risk factors, from multiple studies around the world.Methods and results: The Echocardiographic Normal Ranges Meta-Analysis of the Left heart (EchoNoRMAL) collaboration was established and population-based data sets of echocardiographic measurements combined to perform an individual person data meta-Analysis. Data from 43 studies were received, representing 51 222 subjects, of which 22 404 adults aged 18-80 years were without clinical cardiovascular or renal disease, hypertension or diabetes. Quantile regression or an appropriate parametric regression method will be used to derive reference values at the 5th and 95th centile of each measurement against age. Conclusion: This unique data set represents a large, multi-ethnic cohort of subjects resident in a wide range of countries. The resultant reference ranges will have wide applicability for normative data based on age, sex, and ethnicity. © The Author 2013.