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Normal Reference Intervals for Cardiac Dimensions and Function for Use in Echocardiographic Practice: A Guideline from the British Society of Echocardiography

An Erratum to this article was published on 01 March 2020

This article has been updated

Abstract

This guideline presents reference limits for use in echocardiographic practice, updating previous guidance from the British Society of Echocardiography. The rationale for change is discussed, in addition to how the reference intervals were defined and the current limitations to their use. The importance of interpretation of echocardiographic parameters within the clinical context is explored, as is grading of abnormality. Each of the following echo parameters are discussed and updated in turn: left ventricular linear dimensions and LV mass; left ventricular volumes; left ventricular ejection fraction; left atrial size; right heart parameters; aortic dimensions; and tissue Doppler imaging. There are several important conceptual changes to the assessment of the heart’s structure and function within this guideline. New terminology for left ventricular function and left atrial size are introduced. The British Society of Echocardiography has advocated a new approach to the assessment of the aortic root, the right heart, and clarified the optimal methodology for assessment of LA size. The British Society of Echocardiography has emphasized a preference to use, where feasible, indexed measures over absolute values for any chamber size.

Change history

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Acknowledgments

The authors’ would like to thank Dr Mark Belham for his thoughts and assistance, and the Education Committee of the British Society for Echocardiography for their support. They also acknowledge the authors of NORRE who provided clarification of their published data in order for us to finalise the BSE reference limits.

Funding

This work did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

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Correspondence to Liam Ring MBBS.

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(D X Augustine and V Sharma are the Guidelines Chairs)

D Oxborough and V Sharma are members of the editorial board of Echo Research and Practice. They were not involved in the review or editorial process for this paper, on which they are listed as authors.

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Harkness, A., Ring, L., Augustine, D.X. et al. Normal Reference Intervals for Cardiac Dimensions and Function for Use in Echocardiographic Practice: A Guideline from the British Society of Echocardiography. Echo Res Pract 7, G1–G18 (2020). https://doi.org/10.1530/ERP-19-0050

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  • DOI: https://doi.org/10.1530/ERP-19-0050

Key Words

  • 2D echocardiography
  • guidelines
  • reference ranges