Normal echocardiographic values of 368 Iranian healthy subjects

Background: Echocardiography is widely used to diagnose or exclude cardiac disease. The reports on reference values based on an Asian population are limited. Objectives: We conducted a study to determine normal values for two-dimensional, M-mode, and Doppler echocardiographic measurements and evaluate the relationship between these parameters and age and gender in a large, healthy Iranian population. Patients and Methods: Among a total of 400 volunteers in a cross-sectional study, 368 healthy individuals aged between 30 and 70 years [171 males at a mean age of 47.6 (9.9) and 197 females at a mean age of 47.6 (9.5)] were enrolled. Standard comprehensive transthoracic echocardiography (TTE) was performed based on the guidelines of the American Society of Echocardiography. The normal limits are presented as mean (SD) and are also indexed to body surface area (BSA). Results: There was no significant difference between the men and women regarding left ventricular (LV) ejection fraction (57.97% vs. 57.99%). The mean of LV end-diastolic diameter (LVEDD), LV end-systolic diameter (LVESD), interventricular septum (IVS), posterior wall (PW) thickness, and right ventricular diastolic diameter (RVDd) was significantly greater in the men than in the women. However, there was an inverse relationship when LVEDD, RVDd, and left atrial (LA) diameter and area were indexed to BSA. There was no significant difference in the mean of LA area between the males and females (14.28 vs. 13.6 cm2). The LV diastolic parameters correlated negatively with age. A peakE /A velocity ratio <1 was found in the subjects over 50 years old. The mean of all the measurements in our study was less than the reference values in the published guidelines. Conclusions: Our study, the first and largest investigation of its kind, provides reference values for the echocardiographic evaluation of the cardiac size and function of Iranian healthy individuals. The mean of our measurements was significantly less than that reported in the published guidelines.