Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Department of Cardiology, University of Chicago, Chicago, Illinois.
J Am Soc Echocardiogr. 2023 Jun;36(6):596-603.e3. doi: 10.1016/j.echo.2023.02.004. Epub 2023 Feb 13.
Gender and racial differences in cardiac chamber size are vital to establish normal ranges of cardiac chamber size in healthy subjects. Many studies report either nonindexed raw measurements or measurements indexed to isometric body surface area (BSA) when establishing normal reference values. Other studies advocate allometric indexation for standardization of heart size. We compared several allometric methods on gender and racial differences in left ventricular end-diastolic volume (LVEDV) measured on three-dimensional echocardiography.
Three-dimensional echocardiographic LVEDV data from the World Alliance Societies of Echocardiography normal values study were indexed to isometric BSA, BSA, BSA, isometric height, height, height, and estimated lean body mass. Gender, racial, national, and regional differences in indexed and nonindexed LVEDV were assessed using Cohen's d statistic or Cohen's f statistic, according to the number of groups being compared. Cohen's d < 0.20 and Cohen's f < 0.10 were regarded as very small relative magnitudes of difference.
Differences in LVEDV among White, Black, and Asian races were smallest when BSA or BSA was used for indexation, followed by estimated lean body mass. LVEDV/BSA was nearly identical for men and women (very small, d = 0.05). However, both LVEDV/BSA and LVEDV/BSA still provided moderate relative magnitudes of difference (f = 0.22-0.37) among geographic regions. Specifically, among Asians, Indians had the smallest LVEDV/BSA. Brazilians had the smallest LVEDV/BSA among Whites.
Gender and racial differences in LVEDV became smaller when LVEDV was indexed to BSA or BSA. However, differences in LVEDV among nations remain even after applying allometric scaling. This finding suggests that differences in body composition and/or hemodynamics are potentially more important determinants of heart size than race or gender.
性别和种族差异在心脏腔室大小中至关重要，对于确定健康受试者的心脏腔室大小正常范围具有重要意义。许多研究在建立正常参考值时报告了非索引原始测量值或索引到等比表面积（BSA）的测量值。其他研究则主张使用心脏大小的体表面积指数化进行标准化。我们比较了几种体表面积指数化方法在三维超声心动图测量的左心室舒张末期容积（LVEDV）中的性别和种族差异。
使用世界超声心动图学会联盟正常数值研究的三维超声心动图 LVEDV 数据，对其进行等比表面积（BSA）、BSA、BSA、等比身高、身高和估计瘦体重指数化。使用 Cohen's d 统计量或 Cohen's f 统计量根据比较的组数评估了指数化和非指数化 LVEDV 的性别、种族、国家和地区差异。Cohen's d<0.20 和 Cohen's f<0.10 被认为是差异的非常小相对幅度。
在使用 BSA 或 BSA 进行指数化时，白种人、黑人和亚洲种族之间的 LVEDV 差异最小，其次是估计的瘦体重。男性和女性的 LVEDV/BSA 几乎相同（非常小，d=0.05）。然而，LVEDV/BSA 和 LVEDV/BSA 在地理区域之间仍存在中等相对幅度的差异（f=0.22-0.37）。具体而言，在亚洲人中，印度人的 LVEDV/BSA 最小。在白人中，巴西人的 LVEDV/BSA 最小。
当 LVEDV 索引到 BSA 或 BSA 时，LVEDV 的性别和种族差异变小。然而，即使应用了体表面积指数化，国家之间的 LVEDV 差异仍然存在。这一发现表明，与种族或性别相比，身体成分和/或血液动力学差异可能是心脏大小的更重要决定因素。
