Reference Values of Right Ventricular End-Diastolic Area Defined by Ethnicity and Gender in a Young Adult Population: The CARDIA Study

Background: Despite increasing availability of three-dimensional imaging modalities for estimating right ventricular (RV) size, linear and two-dimensional measures of RV size are the most universally accessible clinical methods. Right ventricular end-diastolic area (RVED area) is known to identify pulmonary pathologies and have prognostic value for cardiovascular mortality in various disease states. To date, there is a paucity of adequately powered studies to define gender- and ethnicity-related differences in normal RVED area. Therefore, we derived gender-based normative values for echocardiographic measurements of RVED area, in a large bi-racial cohort of young adults. Methods: Healthy young adults participants (n = 2088) in the Coronary Artery Risk Development in Young Adults (CARDIA) study, aged 23-35 years, at the time of echocardiogram, were evaluated. RVED area was stratified according to gender and race. The contributions of clinical, allometric and left heart morphology and function to the variability in RVED area were determined. Results: RVED area in males was significantly larger than in females of similar age, but whites had similar values compared to same-gender blacks. RVED area for men and women of > 24.7 cm2 and 20.7cm2, or RVED area indexed to BSA (cm2/m2) of > 12.6 and > 11.7, respectively, are at the 97.5th percentile of normal values. RVED area correlated significantly with left ventricular volume and left atrial size. Lung capacity measured as FVC showed significant body size adjusted correlation with RVED area only in black males. Conclusions: This study provides normative values for echocardiographically defined RV end-diastolic area, and highlights the necessity to use gender-specific normative values. (Echocardiography 2011;28:142-149).