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Variation in left ventricular cardiac magnetic resonance normal reference ranges: systematic review and meta-analysis
AIMS: To determine population-related and technical sources of variation in cardiac magnetic resonance (CMR) reference ranges for left ventricular (LV) quantification through a formal systematic review and meta-analysis. METHODS AND RESULTS: This study is registered with the International Prospectiv...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8081427/ https://www.ncbi.nlm.nih.gov/pubmed/32460308 http://dx.doi.org/10.1093/ehjci/jeaa089 |
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author | Raisi-Estabragh, Zahra Kenawy, Asmaa A M Aung, Nay Cooper, Jackie Munroe, Patricia B Harvey, Nicholas C Petersen, Steffen E Khanji, Mohammed Y |
author_facet | Raisi-Estabragh, Zahra Kenawy, Asmaa A M Aung, Nay Cooper, Jackie Munroe, Patricia B Harvey, Nicholas C Petersen, Steffen E Khanji, Mohammed Y |
author_sort | Raisi-Estabragh, Zahra |
collection | PubMed |
description | AIMS: To determine population-related and technical sources of variation in cardiac magnetic resonance (CMR) reference ranges for left ventricular (LV) quantification through a formal systematic review and meta-analysis. METHODS AND RESULTS: This study is registered with the International Prospective Register of Systematic Reviews (CRD42019147161). Relevant studies were identified through electronic searches and assessed by two independent reviewers based on predefined criteria. Fifteen studies comprising 2132 women and 1890 men aged 20–91 years are included in the analysis. Pooled LV reference ranges calculated using random effects meta-analysis with inverse variance weighting revealed significant differences by age, sex, and ethnicity. Men had larger LV volumes and higher LV mass than women [LV end-diastolic volume (mean difference = 6.1 mL/m(2), P-value = 0.014), LV end-systolic volume (MD = 4 mL/m(2), P-value = 0.033), LV mass (mean difference = 12 g/m(2), P-value = 7.8 [Formula: see text] 10(−9))]. Younger individuals had larger LV end-diastolic volumes than older ages (20–40 years vs. ≥65 years: women MD = 14.0 mL/m(2), men MD = 14.7 mL/m(2)). East Asians (Chinese, Korean, Singaporean-Chinese, n = 514) had lower LV mass than Caucasians (women: MD = 6.4 g/m(2), P-value = 0.016; men: MD = 9.8 g/m(2), P-value = 6.7 [Formula: see text] 10(−5)). Between-study heterogeneity was high for all LV parameters despite stratification by population-related factors. Sensitivity analyses identified differences in contouring methodology, magnet strength, and post-processing software as potential sources of heterogeneity. CONCLUSION: There is significant variation between CMR normal reference ranges due to multiple population-related and technical factors. Whilst there is need for population-stratified reference ranges, limited sample sizes and technical heterogeneity precludes derivation of meaningful unified ranges from existing reports. Wider representation of different populations and standardization of image analysis is urgently needed to establish such reference distributions. |
format | Online Article Text |
id | pubmed-8081427 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-80814272021-05-03 Variation in left ventricular cardiac magnetic resonance normal reference ranges: systematic review and meta-analysis Raisi-Estabragh, Zahra Kenawy, Asmaa A M Aung, Nay Cooper, Jackie Munroe, Patricia B Harvey, Nicholas C Petersen, Steffen E Khanji, Mohammed Y Eur Heart J Cardiovasc Imaging Review AIMS: To determine population-related and technical sources of variation in cardiac magnetic resonance (CMR) reference ranges for left ventricular (LV) quantification through a formal systematic review and meta-analysis. METHODS AND RESULTS: This study is registered with the International Prospective Register of Systematic Reviews (CRD42019147161). Relevant studies were identified through electronic searches and assessed by two independent reviewers based on predefined criteria. Fifteen studies comprising 2132 women and 1890 men aged 20–91 years are included in the analysis. Pooled LV reference ranges calculated using random effects meta-analysis with inverse variance weighting revealed significant differences by age, sex, and ethnicity. Men had larger LV volumes and higher LV mass than women [LV end-diastolic volume (mean difference = 6.1 mL/m(2), P-value = 0.014), LV end-systolic volume (MD = 4 mL/m(2), P-value = 0.033), LV mass (mean difference = 12 g/m(2), P-value = 7.8 [Formula: see text] 10(−9))]. Younger individuals had larger LV end-diastolic volumes than older ages (20–40 years vs. ≥65 years: women MD = 14.0 mL/m(2), men MD = 14.7 mL/m(2)). East Asians (Chinese, Korean, Singaporean-Chinese, n = 514) had lower LV mass than Caucasians (women: MD = 6.4 g/m(2), P-value = 0.016; men: MD = 9.8 g/m(2), P-value = 6.7 [Formula: see text] 10(−5)). Between-study heterogeneity was high for all LV parameters despite stratification by population-related factors. Sensitivity analyses identified differences in contouring methodology, magnet strength, and post-processing software as potential sources of heterogeneity. CONCLUSION: There is significant variation between CMR normal reference ranges due to multiple population-related and technical factors. Whilst there is need for population-stratified reference ranges, limited sample sizes and technical heterogeneity precludes derivation of meaningful unified ranges from existing reports. Wider representation of different populations and standardization of image analysis is urgently needed to establish such reference distributions. Oxford University Press 2020-05-27 /pmc/articles/PMC8081427/ /pubmed/32460308 http://dx.doi.org/10.1093/ehjci/jeaa089 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Raisi-Estabragh, Zahra Kenawy, Asmaa A M Aung, Nay Cooper, Jackie Munroe, Patricia B Harvey, Nicholas C Petersen, Steffen E Khanji, Mohammed Y Variation in left ventricular cardiac magnetic resonance normal reference ranges: systematic review and meta-analysis |
title | Variation in left ventricular cardiac magnetic resonance normal reference ranges: systematic review and meta-analysis |
title_full | Variation in left ventricular cardiac magnetic resonance normal reference ranges: systematic review and meta-analysis |
title_fullStr | Variation in left ventricular cardiac magnetic resonance normal reference ranges: systematic review and meta-analysis |
title_full_unstemmed | Variation in left ventricular cardiac magnetic resonance normal reference ranges: systematic review and meta-analysis |
title_short | Variation in left ventricular cardiac magnetic resonance normal reference ranges: systematic review and meta-analysis |
title_sort | variation in left ventricular cardiac magnetic resonance normal reference ranges: systematic review and meta-analysis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8081427/ https://www.ncbi.nlm.nih.gov/pubmed/32460308 http://dx.doi.org/10.1093/ehjci/jeaa089 |
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