Background

Echocardiographic assessment of right ventricular (RV) systolic function is an important component of clinical decision making. Although professional societies have worked to define normal ranges of RV size and function, their guidelines have not included the impacts of age, sex, and ethnicity on these parameters, as they have for the left ventricle. The World Alliance of Societies of Echocardiography study was designed to investigate the effects of age, sex, and ethnicity on all cardiac chambers. The aim of this study was to explore whether these differences exist for RV systolic parameters.

Methods

Adequate two-dimensional RV-focused views for the measurement of systolic parameters, including fractional area change and global and free wall longitudinal strain, were available in 1,913 subjects (mean age, 47 ± 17 years; 51% men). Basal and mid-RV dimensions, length, tricuspid annular peak systolic excursion, tissue Doppler S′ velocity, and myocardial performance index were also measured. Subjects were grouped by age (<40, 41–65, and >65 years), with results also stratified by sex and ethnicity (Asian, black, or white) and analyzed using vendor-independent software. Differences among groups were evaluated using analysis of variance.

Results

Women had smaller absolute and indexed RV areas and absolute RV dimensions and higher magnitudes of fractional area change, free wall strain, and global longitudinal strain compared to men. With respect to age, most of the statistically significant differences were noted between the <40- and >65-year age groups, with RV areas and lengths smaller in older age groups and RV functional parameters (S′, fractional area change, tricuspid annular plane systolic excursion, global longitudinal strain, free wall strain, and myocardial performance index) showing minimal decreases or no changes with age. Although there were no meaningful differences in functional parameters among ethnic groups, RV size was smallest in Asians.

Conclusions

These findings suggest that although two-dimensional RV parameters are age and sex dependent, association with race is less apparent, excepting that the Asian population appears to have smaller chamber sizes compared with whites and blacks.

中文翻译：

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按性别、年龄和种族分层的二维超声心动图右心室大小和收缩功能测量：世界超声心动图研究学会联盟的结果

背景

右心室 (RV) 收缩功能的超声心动图评估是临床决策的重要组成部分。尽管专业协会已努力定义 RV 大小和功能的正常范围，但他们的指南并未像对左心室那样包括年龄、性别和种族对这些参数的影响。世界超声心动图学会联盟研究旨在调查年龄、性别和种族对所有心腔的影响。本研究的目的是探讨 RV 收缩参数是否存在这些差异。

方法

在 1,913 名受试者（平均年龄，47 ± 17 岁；51% 男性）中可以获得用于测量收缩参数的二维 RV 聚焦视图，包括面积变化和全局和游离壁纵向应变。还测量了基底部和中间 RV 尺寸、长度、三尖瓣环峰值收缩偏移、组织多普勒 S' 速度和心肌性能指数。受试者按年龄分组（<40、41-65 和 >65 岁），结果也按性别和种族（亚洲、黑人或白人）分层，并使用独立于供应商的软件进行分析。使用方差分析评估组间差异。

结果

与男性相比，女性的绝对和索引 RV 面积和绝对 RV 尺寸更小，而面积变化、游离壁应变和整体纵向应变的幅度更大。在年龄方面，<40 岁和 >65 岁年龄组之间出现了大部分统计学显着差异，年龄较大组的 RV 面积和长度以及 RV 功能参数（S'、面积变化分数、三尖瓣环平面收缩偏移、整体纵向应变、游离壁应变和心肌性能指数）显示随着年龄的增长最小减少或没有变化。尽管不同种族之间的功能参数没有显着差异，但亚洲人的 RV 大小最小。

结论

这些发现表明，尽管二维 RV 参数依赖于年龄和性别，但与种族的关联并不那么明显，除了与白人和黑人相比，亚洲人口的腔室尺寸似乎更小。