Background: The World Alliance Societies of Echocardiography (WASE) Normal Values Study evaluates individuals from multiple countries and races with the aim of describing normative values that could be applied to the global community worldwide and to determine differences and similarities among people from different countries and races. The present report focuses specifically on two-dimensional (2D) left ventricular (LV) dimensions, volumes, and systolic function. Methods: The WASE Normal Values Study is a multicenter international, observational, prospective, crosssectional study of healthy adult individuals. Participants recruited in each country were evenly distributed among six predetermined subgroups according to age and gender. Comprehensive 2D transthoracic echocardiograms were acquired and analyzed following strict protocols based on recent American Society of Echocardiography and European Association of Cardiovascular Imaging guidelines. Analysis was performed at the WASE 2D core laboratory and included 2D LV dimensions, LV volumes, and LV ejection fraction (LVEF) by the biplane Simpson method and global longitudinal strain (GLS). Results: Two thousand eight subjects were enrolled in 15 countries. The median age was 45 years (interquartile range, 32-65 years), 42.8% were white, 41.8% were Asian, and 9.7% were black. LV dimensions and volumes were larger in male subjects, while LVEF and GLS were higher in female subjects. Global
The goal of this study was to evaluate the role of Doppler time interval-derived myocardial performance index (MPI) in the setting of acute right ventricular myocardial infarction (RVMI). Inferior myocardial infarction is accompanied by RVMI in over a third of cases. We do not have easily applicable noninvasive tools for reliably quantifying the right ventricular (RV) dysfunction in RVMI and to serially follow alterations. Clinical and echocardiography data of all acute inferior myocardial infarction (IMI) admissions (n = 135) to our referral teaching institute were prospectively collected for the study. After exclusions, study group comprised of 36 patients with RVMI diagnosed by >/=1 mm ST segment elevation in V3R-V5R of right-sided ECG and 63 patients without RVMI constituted the control group. All patients underwent echocardiography within 24 hours of admission. Normal range of MPI for our laboratory was estimated from 50 age-matched healthy subjects. RV MPI was elevated to a mean of 0.53 +/- 0.22 in RVMI (Normal MPI 0.20 +/- 0.05, P-value < 0.001). IMI without RVMI did not elevate MPI significantly (0.21 +/- 0.17, P-value NS). Repeat MPI estimation in 11 RVMI (7 thrombolyzed) patients after 5 days showed dramatic reduction (0.23 +/- 0.12, P-value < 0.001). This reduction was noted irrespective of thrombolysis. RV MPI >/= 0.30 has high sensitivity (82%) and specificity (95%) for the diagnosis of RVMI in the presence of acute IMI. MPI can reliably diagnose RV infarction. It can be used to quantify right ventricular dysfunction and assess acute improvements in RV function.
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