Petersen Steffen E, Aung Nay, Sanghvi Mihir M, Zemrak Filip, Fung Kenneth, Paiva Jose Miguel, Francis Jane M, Khanji Mohammed Y, Lukaschuk Elena, Lee Aaron M, Carapella Valentina, Kim Young Jin, Leeson Paul, Piechnik Stefan K, Neubauer Stefan
William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, UK.
J Cardiovasc Magn Reson. 2017 Feb 3;19(1):18. doi: 10.1186/s12968-017-0327-9.
Cardiovascular magnetic resonance (CMR) is the gold standard method for the assessment of cardiac structure and function. Reference ranges permit differentiation between normal and pathological states. To date, this study is the largest to provide CMR specific reference ranges for left ventricular, right ventricular, left atrial and right atrial structure and function derived from truly healthy Caucasian adults aged 45-74.
Five thousand sixty-five UK Biobank participants underwent CMR using steady-state free precession imaging at 1.5 Tesla. Manual analysis was performed for all four cardiac chambers. Participants with non-Caucasian ethnicity, known cardiovascular disease and other conditions known to affect cardiac chamber size and function were excluded. Remaining participants formed the healthy reference cohort; reference ranges were calculated and were stratified by gender and age (45-54, 55-64, 65-74).
After applying exclusion criteria, 804 (16.2%) participants were available for analysis. Left ventricular (LV) volumes were larger in males compared to females for absolute and indexed values. With advancing age, LV volumes were mostly smaller in both sexes. LV ejection fraction was significantly greater in females compared to males (mean ± standard deviation [SD] of 61 ± 5% vs 58 ± 5%) and remained static with age for both genders. In older age groups, LV mass was lower in men, but remained virtually unchanged in women. LV mass was significantly higher in males compared to females (mean ± SD of 53 ± 9 g/m vs 42 ± 7 g/m). Right ventricular (RV) volumes were significantly larger in males compared to females for absolute and indexed values and were smaller with advancing age. RV ejection fraction was higher with increasing age in females only. Left atrial (LA) maximal volume and stroke volume were significantly larger in males compared to females for absolute values but not for indexed values. LA ejection fraction was similar for both sexes. Right atrial (RA) maximal volume was significantly larger in males for both absolute and indexed values, while RA ejection fraction was significantly higher in females.
We describe age- and sex-specific reference ranges for the left ventricle, right ventricle and atria in the largest validated normal Caucasian population.
心血管磁共振成像（CMR）是评估心脏结构和功能的金标准方法。参考范围有助于区分正常和病理状态。迄今为止，本研究是规模最大的一项，旨在为年龄在45 - 74岁的真正健康的白种成年人提供左心室、右心室、左心房和右心房结构及功能的CMR特定参考范围。
5065名英国生物银行参与者接受了1.5特斯拉稳态自由进动成像的CMR检查。对所有四个心腔进行了手动分析。排除非白种人、已知心血管疾病以及其他已知会影响心腔大小和功能的疾病患者。其余参与者组成健康参考队列；计算参考范围，并按性别和年龄（45 - 54岁、55 - 64岁、65 - 74岁）进行分层。
应用排除标准后，804名（16.2%）参与者可供分析。男性的左心室（LV）绝对容积和指数容积均大于女性。随着年龄增长，两性的左心室容积大多变小。女性的左心室射血分数显著高于男性（平均±标准差[SD]为61±5%对58±5%），且两性随年龄增长均保持稳定。在老年组中，男性的左心室质量较低，但女性的左心室质量几乎不变。男性的左心室质量显著高于女性（平均±SD为53±9 g/m对42±7 g/m）。男性的右心室（RV）绝对容积和指数容积均显著大于女性，且随年龄增长而变小。仅女性的右心室射血分数随年龄增长而升高。男性的左心房（LA）最大容积和每搏输出量的绝对值显著大于女性，但指数值并非如此。两性的左心房射血分数相似。男性的右心房（RA）最大容积的绝对值和指数值均显著大于女性，而女性的右心房射血分数显著更高。
我们在最大规模的经过验证的正常白种人群中描述了左心室、右心室和心房的年龄及性别特异性参考范围。
