Table 2.
Required and Optional Parameters; Echocardiographic Views or Formulas; Percentages with Measurable Images; Body Surface Area Transformation α; Effects of Age, Sex, and Race on Measurements; and Final Z-Score Models
| Parameter | Unit | Req | Echocardiographic View or Formula | % Av | α | Effects | % Diff | Slope Δ | Mean | SD |
|---|---|---|---|---|---|---|---|---|---|---|
| MVAP | cm | Yes | Parasternal long-axis | 100% | 0.50 | A | 1.33% | N | 2.31 | 0.24 |
| MVLAT | cm | Yes | Apical four-chamber | 100% | 0.50 | A S | 2.36% | N | 2.23 | 0.22 |
| MVA | cm2 | Yes | π/4 x MVAP x MVLAT | 100% | 1.00 | A | 3.68% | N | 4.06 | 0.68 |
| TVAP | cm | Yes | Parasternal long-axis | 100% | 0.50 | A S A* S | 1.33% | N | 2.36 | 0.28 |
| TVLAT | cm | Yes | Apical four-chamber | 100% | 0.50 | A R S A* S | 4.25% | N | 2.36 | 0.29 |
| TVA | cm2 | Yes | π/4 x TVAP x TVLAT | 100% | 1.00 | A R S A* R A* S | 3.87% | N | 4.39 | 0.83 |
| ANN | cm | Yes | Parasternal long-axis | 100% | 0.50 | A R S A* S S* R | 1.55% | Y | 1.48 | 0.14 |
| ROOT | cm | Yes | Parasternal long-axis | 100% | 0.50 | A R S A* R A* S | 1.92% | N | 2.06 | 0.18 |
| STJ | cm | Yes | Parasternal long-axis | 100% | 0.50 | A R S S* R | 1.35% | Y | 1.69 | 0.16 |
| AAO | cm | Yes | Parasternal long-axis | 100% | 0.50 | A R S | 1.13% | N | 1.79 | 0.18 |
| ARCHPROX | cm | No† | Suprasternal long-axis | 80% | 0.50 | A R S | 4.72% | Y | 1.53 | 0.23 |
| ARCHDIST | cm | No† | Suprasternal long-axis | 97% | 0.50 | A R | 2.36% | N | 1.36 | 0.19 |
| ISTH | cm | No† | Suprasternal long-axis | 97% | 0.50 | A R | 1.89% | Y | 1.25 | 0.18 |
| LMCA | mm | No† | Parasternal short-axis | 90% | 0.45 | A R S | 2.78% | N | 2.95 | 0.57 |
| LAD | mm | No† | Parasternal short-axis | 78% | 0.45 | A S | 2.59% | N | 1.90 | 0.34 |
| RCA | mm | No† | Parasternal short-axis | 91% | 0.45 | R S | 2.42% | N | 2.32 | 0.55 |
| PVSAX | cm | Yes* | Parasternal short-axis | 71% | 0.50 | A R S A* R A* S S* R A* S* R | 1.42% | Y | 1.91 | 0.24 |
| PVLAX | cm | Yes* | Parasternal long-axis | 90% | 0.50 | A R S A* S | 4.59% | Y | 2.01 | 0.28 |
| MPA | cm | No† | Parasternal short-axis | 94% | 0.50 | A A* S S* R | 2.00% | Y | 1.82 | 0.24 |
| RPA | cm | No† | Parasternal short-axis | 93% | 0.50 | A S | 1.18% | Y | 1.07 | 0.18 |
| LPA | cm | No† | Parasternal short-axis | 89% | 0.50 | A S | 0.87% | Y | 1.10 | 0.18 |
| LVEDD | cm | Yes | Parasternal short-axis | 100% | 0.45 | A R S A* S | 1.60% | Y | 3.89 | 0.33 |
| LVPWT | cm | Yes | Parasternal short-axis | 100% | 0.40 | A R S A* R A* S | 2.82% | Y | 0.57 | 0.09 |
| LVST | cm | Yes | Parasternal short-axis | 100% | 0.40 | A R S A* R A* S | 2.88% | Y | 0.58 | 0.09 |
| LVEDL | cm | Yes | Apical four-chamber | 100% | 0.45 | A R S A* S | 1.29% | N | 6.31 | 0.46 |
| LVEDLEPI | cm | Yes | Apical four-chamber | 100% | 0.45 | A R S A* S | 1.22% | N | 6.87 | 0.45 |
| LVEDA | cm2 | Yes | Parasternal short-axis | 100% | 0.90 | A S A* S | 2.84% | Y | 11.91 | 1.89 |
| LVEDAEPI | cm2 | Yes | Parasternal short-axis | 100% | 0.90 | A R S A* S | 2.79% | N | 20.00 | 2.59 |
| LVEDV | ml | Yes | 5/6 x LVEDA x LVEDL | 100% | 1.30 | A R S A* S | 4.97% | Y | 62.02 | 11.94 |
| LVEDVEPI | ml | Yes | 5/6 x LVEDAEPI x LVEDLEPI | 100% | 1.30 | A S A* S | 4.20% | N | 113.14 | 17.85 |
| LVM | gm | Yes | 1.05 x (LVEDVEPI – LVEDV) | 100% | 1.25 | A R S A* S | 5.00% | N | 53.02 | 9.06 |
| LVMTV‡ | gm/ml | Yes | LVM/LVEDV | 100% | 0‡ | A R | 4.52% | Y | 0.88 | 0.16 |
| LVTTD‡ | none | Yes | LVPWT/LVEDD | 100% | 0 ‡ | A R A* R | 4.07% | Y | 0.15 | 0.03 |
| LVSI‡ | none | Yes | LVEDL/LVEDD | 100% | 0 ‡ | A R S | 1.05% | N | 1.63 | 0.17 |
For pulmonary annular diameters, a parasternal short- and/or long-axis measurement was required.
For optional measurements, each study must contain all 3 measurements from only one of the following groups: 1) ARCH (PROX), ARCH (DIST), ISTH; 2) LMCA, LAD, RCA; 3) MPA, RPA, LPA.
These parameters do not have a significant relationship with BSA, so BSA is not used in Z-score derivation.
Parameter Abbreviations: AAO=ascending aortic diameter; ANN=aortic annular diameter; ARCHDIST=distal transverse arch diameter; ARCHPROX=proximal transverse arch diameter; ISTH=aortic isthmus diameter; LAD=proximal left anterior descending coronary artery diameter; LMCA=left main coronary artery diameter; LPA=left pulmonary artery diameter; LVEDA=LV (LV) short-axis end-diastolic endocardial area; LVEDAEPI=LV short-axis end-diastolic epicardial area; LVEDD=LV short-axis end-diastolic endocardial diameter; LVEDL=LV long-axis end-diastolic endocardial length; LVEDLEPI=LV long-axis end-diastolic epicardial length; LVEDV=LV short-axis end-diastolic endocardial volume; LVEDVEPI=LV short-axis end-diastolic epicardial volume; LVM=LV mass; LVMTV=LV mass-to-volume ratio; LVPWT=LV short-axis end-diastolic posterior wall thickness; LVSI=LV sphericity index; LVST=LV short-axis end-diastolic septal thickness; LVTTD=LV thickness-to-dimension ratio; MPA=main pulmonary artery diameter; MVAP=mitral anteroposterior diameter; MVLAT=mitral lateral diameter; MVA=mitral area; PVLAX=pulmonary annular long-axis diameter; PVSAX=pulmonary annular short-axis diameter; RCA=proximal right coronary artery diameter; ROOT=aortic root diameter; RPA=right pulmonary artery diameter; STJ=sinotubular junction; TVAP=tricuspid anteroposterior diameter; TVLAT=tricuspid lateral diameter; TVA= tricuspid area. Column Labels: Req=required parameter; % Av=percent of studies with available images; α=exponent for BSA transformation (BSAα); Effects=statistically significant effects and interactions with multivariable regression; % Diff=percent differences of mean indexed values for models with and without significant effects and interactions; Slope Δ=slope change at ~6 years age in indexed parameter versus age relationships; Mean=mean indexed parameter value; SD=standard deviation of indexed parameter. Effects Abbreviations: A=age; R=race; S=sex; A*R=interaction between age and race; A*S=interaction between age and sex; S*R=interaction between sex and race; A*S*R=interaction among age, sex, and race.