Normal sex and age-specific parameters in a multi-ethnic population: a cardiovascular magnetic resonance study of the Canadian Alliance for Healthy Hearts and Minds cohort

Judy M Luu; Catherine Gebhard; Chinthanie Ramasundarahettige; Dipika Desai; Karleen Schulze; Francois Marcotte; Philip Awadalla; Philippe Broet; Trevor Dummer; Jason Hicks; Eric Larose; Alan Moody; Eric E Smith; Jean-Claude Tardif; Tiago Teixeira; Koon K Teo; Jennifer Vena; Douglas S Lee; Sonia S Anand; Matthias G Friedrich; CAHHM Study Investigators

doi:10.1186/s12968-021-00819-z

Normal sex and age-specific parameters in a multi-ethnic population: a cardiovascular magnetic resonance study of the Canadian Alliance for Healthy Hearts and Minds cohort

J Cardiovasc Magn Reson. 2022 Jan 3;24(1):2. doi: 10.1186/s12968-021-00819-z.

Authors

Judy M Luu^#¹, Catherine Gebhard^#^{2

3}, Chinthanie Ramasundarahettige^{4

5}, Dipika Desai⁴, Karleen Schulze^{4

5}, Francois Marcotte⁶, Philip Awadalla⁷, Philippe Broet^{8

9}, Trevor Dummer¹⁰, Jason Hicks¹¹, Eric Larose¹², Alan Moody¹³, Eric E Smith¹⁴, Jean-Claude Tardif⁶, Tiago Teixeira¹⁵, Koon K Teo^{4

5

16}, Jennifer Vena¹⁷, Douglas S Lee^{18

19}, Sonia S Anand^{4

5

16}, Matthias G Friedrich²⁰; CAHHM Study Investigators

Affiliations

¹ Division of Cardiology, Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.
² Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
³ Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland.
⁴ Population Health Research Institute, Hamilton Health Sciences, McMaster University, 237 Barton St East, Hamilton, ON, L8L 2X2, Canada.
⁵ Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
⁶ Research Centre, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street, Montreal, QC, H1T 1C8, Canada.
⁷ Department of Molecular Genetics, Ontario Institute for Cancer Research, University of Toronto, 661 University Avenue Suite 510, Toronto, ON, M5G 0A3, Canada.
⁸ Department of Preventive and Social Medicine, École de Santé Publique, Université de Montréal, 3175 Chemin de la Cote-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada.
⁹ Research Centre, CHU Sainte Justine, 3175 Chemin de la Cote-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada.
¹⁰ School of Population and Public Health, Cancer Control Research, BC Cancer, University of British Columbia, 675 W 10th Avenue, Vancouver, BC, V5Z 1L3, Canada.
¹¹ Atlantic PATH, Dalhousie University, 1494 Carlton Street, P.O. Box 15000, Halifax, NS, B3H 4R2, Canada.
¹² Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval, 2725 chemin Sainte-Foy, Quebec, G1V 4G5, Canada.
¹³ Sunnybrook Health Science Centre, Toronto, ON, Canada.
¹⁴ Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
¹⁵ Cardiology Department, Entre Douro e Vouga Hospital Centre, Santa Maria Feira, Portugal.
¹⁶ Department of Health Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
¹⁷ Cancer Research and Analytics, Cancer Control Alberta, Alberta Health Services, Suite 1500 Sun Life Place, 10123 99th Street NW, Edmonton, AB, T5J 3H1, Canada.
¹⁸ Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
¹⁹ Peter Munk Cardiac Centre University Health Network University of Toronto, Toronto, ON, Canada.
²⁰ Department of Medicine and Diagnostic Radiology, McGill University, 1001 Decarie Boulevard, Montreal, QC, H4A 3J1, Canada. mgwfriedrich@gmail.com.

^# Contributed equally.

Abstract

Background: Despite the growing utility of cardiovascular magnetic resonance (CMR) for cardiac morphology and function, sex and age-specific normal reference values derived from large, multi-ethnic data sets are lacking. Furthermore, most available studies use a simplified tracing methodology. Using a large cohort of participants without history of cardiovascular disease (CVD) or risk factors from the Canadian Alliance for Healthy Heart and Minds, we sought to establish a robust set of reference values for ventricular and atrial parameters using an anatomically correct contouring method, and to determine the influence of age and sex on ventricular parameters.

Methods and results: Participants (n = 3206, 65% females; age 55.2 ± 8.4 years for females and 55.1 ± 8.8 years for men) underwent CMR using standard methods for quantitative measurements of cardiac parameters. Normal ventricular and atrial reference values are provided: (1) for males and females, (2) stratified by four age categories, and (3) for different races/ethnicities. Values are reported as absolute, indexed to body surface area, or height. Ventricular volumes and mass were significantly larger for males than females (p < 0.001). Ventricular ejection fraction was significantly diminished in males as compared to females (p < 0.001). Indexed left ventricular (LV) end-systolic, end-diastolic volumes, mass and right ventricular (RV) parameters significantly decreased as age increased for both sexes (p < 0.001). For females, but not men, mean LV and RVEF significantly increased with age (p < 0.001).

Conclusion: Using anatomically correct contouring methodology, we provide accurate sex and age-specific normal reference values for CMR parameters derived from the largest, multi-ethnic population free of CVD to date.

Clinical trial registration: ClinicalTrials.gov, NCT02220582. Registered 20 August 2014-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02220582 .

Keywords: Age; Cardiovascular magnetic resonance; Normal; Reference; Sex.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Age Factors
Canada
Female
Heart Ventricles* / diagnostic imaging
Humans
Magnetic Resonance Imaging, Cine
Magnetic Resonance Spectroscopy
Male
Middle Aged
Predictive Value of Tests
Reference Values
Sex Factors
Stroke Volume
Ventricular Function, Left*

Associated data

ClinicalTrials.gov/NCT02220582

Abstract

Publication types

MeSH terms

Associated data

Grants and funding