Normal Echo reference values

[Victric]

Hi.

I'm a bit confused about reference values for cardiac dimensions on echo. According to The American Society of Echocardiography, the normal dimensions for the left ventricle at diastole is < 60 mm. Others say that 55 mm is the normal upper limit. Yet others say absolute values are useless and that you should index for body surface are or height.

Personally, I have a left ventricular diameter of 57 mm, and would like to know if that is considered normal? BSa of 2,0 mm, 193 cm.

[Victric]

Okay, I guess that's one of the many things that vary among different labs and cardiologist. I suppose the best thing is to relate to the values your own cardiologist uses.

[anacyde]

From a cardiologist.

[Victric]

Where do you find the 2,7 cm meassurement? According to The American Society of Echocardiography, normal is less than 3,1 cm per m2, which is much larger.

[anacyde]

Whoever said that you need your body surface area is correct.

A simple formula if you know your end diastolic dimension is EDD/BSA to determine if your heart size is normal for you.  In your case, this would then be 5.7 divided by 2.0 = 2.85 cms (normal is less than 2.7 cms per meter squared body surface area).  Based on this it would appear that your LV is ever so slightly enlarged, but probably within normal limits given your level of acivity - which this calculation does not factor in.

Hope this helps :)

[rasp]

Interesting that this post was just created.  My Cardiologist basically told me my heart was minimally enlarged, at 5.6 cm (translates to 56 mm), but he's not concerned simply because my heart muscle is strong and all the valves and such are in perfect working order.  After researching, I have found a lot of people have different takes as to what qualifies as a minimally enlarged heart, and it seems Cardiologists can view them differently.

Thanks for the post, va_tony.

[Victric]

Thanks for the post!

I'm not an athlete, but when performing an exercise test on a bicycle, I landed on 125 % of normal, which would place me above the 2 SDs considered "normal", so I guess I am quite fit. I guess that as long as I don't have any significant symptoms (except for my PVCs, which come and go...) there's no reason to be concerned.

[va_tony]

Obviously one size does not fit all and ventricular diameter should be indexed to body surface area and/or height. I personally don't like BSA because it discriminates against tall people (like you I am tall, 191 cm). Refer to Table 3 in the JACC paper "Association of fat-free mass and training status with left ventricular size and mass in endurance-trained athletes" by Gillian A. Whalley et al, J Am Coll Cardiol, 2004; 44:892-896, doi:10.1016/j.jacc.2004.04.051 (it's found at http://content.onlinejacc.org/cgi/content/full/44/4/892#TBL1 ). They give the following values for "untrained" normal individuals (the value for trained atheletes are larger):
LVEDD/BSA (mm/m2) = 26.9 plus or minus 0.38
LVEDD/height (mm/m) = 29.7 plus or minus 0.47

A 2.0 m2 BSA translates to a value of 53.8 mm plus or minus 0.76 mm. So, on a BSA basis, your 57 mm is a little above normal unless you're an athlete (which showed mid-range vales of 57 mm). A height of 1.93 m tranlates to roughly 59 mm plus or minus 1 mm.  So your 57 mm stacks up in the normal range there (and small for an athlete).

It seems to me that your left ventricular diameter is normal.