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Journal of Cardiovascular Magnetic Resonance

, 18:21

First Online: 12 April 2016Received: 23 December 2015Accepted: 22 March 2016


BackgroundCardiovascular magnetic resonance CMR reference ranges have not been well established in Chinese. Here we determined normal cardiac and aortic reference ranges in healthy Singaporean Chinese and investigated how these data might affect clinical interpretation of CMR scans.

MethodsIn 180 healthy Singaporean Chinese 20 to 69 years old; males, n = 91, comprehensive cardiac assessment was performed using the steady state free precision technique 3T Ingenia, Philips and images were analysed by two independent observers CMR42, Circle Cardiovascular Imaging. Measurements were internally validated using standardized approaches: left ventricular mass LVM was measured in diastole and systole with and without papillary muscles and stroke volumes were compared in both ventricles. All reference ranges were stratified by sex and age; and -indeterminate-borderline- regions were defined statistically at the limits of the normal reference ranges. Results were compared with clinical measurements reported in the same individuals.

ResultsLVM was equivalent in both phases mean difference 3.0 ± 2.5 g; P = 0.22 and stroke volumes were not significantly different in the left and right ventricles P = 0.91. Compared to females, males had larger left and right ventricular volumes P < 0.001 for all. Indexed LVM was significantly higher in males compared to females 50 ± 7 versus 38 ± 5 g-m, respectively; P < 0.001. Overall, papillary muscles accounted for only ~2 % of the total LVM. Indexed atrial sizes and aortic root dimensions were similar between males and females P > 0.05 for all measures. In both sexes, age correlated negatively with left and right ventricular volumes; and positively with aortic sinus and sinotubular junction diameters P < 0.0001 for all. There was excellent agreement in indexed stroke volumes in the left and right ventricles 0.1±5.7mL-m, 0.7±6.2 mL-m, respectively, LVM 0.6±6.4g-m, atrial sizes and aortic root dimensions between values reported in clinical reports and our measured reference ranges.

ConclusionsComprehensive sex and age-corrected CMR reference ranges at 3T have been established in Singaporean Chinese. This is an important step for clinical practice and research studies of the heart and aorta in Asia.

KeywordsCardiovascular magnetic resonance Normal reference ranges Ventricular volumes Ventricular function AbbreviationsBSABody surface area

CMRCardiovascular magnetic resonance

EDVEnd diastolic volume

ESVEnd systolic volume

FGEFast gradient echo

LALeft atrial

LVLeft ventricular-left ventricle

LVMLeft ventricular mass

RARight atrial

RVRight ventricular-right ventricle

SSFPSteady state free precision

STJSino-tubular junction

Stuart A Cook and Calvin Woon-Loong Chin are senior authors.

Electronic supplementary materialThe online version of this article doi:10.1186-s12968-016-0236-3 contains supplementary material, which is available to authorized users.

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Autor: Thu-Thao Le - Ru San Tan - Michelle De Deyn - Elizabeth Pee Chong Goh - Yiying Han - Bao Ru Leong - Stuart Alexander Coo


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