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Clin Physiol Funct Imaging. 2015 Jul;35(4):275-82. doi: 10.1111/cpf.12161. Epub 2014 May 8.

Individual reference values for 2D echocardiographic measurements. The Stockholm - Umeå Study.

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Department of Clinical Physiology, Capio S:t Görans Hospital, Karolinska Institute, Stockholm, Sweden.
Departments of Clinical Physiology and Nuclear Medicine, Danderyds Hospital, Karolinska Institute, Stockholm, Sweden.
Department of Clinical Physiology, Heart Centre, Umeå University, Umeå, Sweden.
Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
Department of Clinical Physiology, Södersjukhuset, Karolinska Institute, Stockholm, Sweden.



Improved reference values for 2D echocardiographic measurements are required, even when more recent echocardiographic technology is employed. In addition, it may be preferable to individualize reference values from age, gender and body characteristics of any subject.


A material of 180 healthy subjects was collected and investigated, aiming for an even distribution of sex and age (from 20 to 80 years of age; the Stockholm material). For atrial areas, material from another 216 healthy subjects with similar sex and age distribution was added (the Umeå material). The 2D measures determined were the left and right ventricular diameters in diastole, the left ventricular diameter in systole, the thickness of septum and posterior wall, the diameters of the aortic root (sinotubular junction) and the left atrium (all in parasternal view), together with the left and right ventricular diameters in diastole and left and right atrial areas in end-systole (apical four-chamber view). The width of the inferior vena cava (from subcostal view) was also determined.


Confidence intervals for females and males are presented for each of these measures. Multiple linear regression analyses with age, sex and measures of body characteristics as predictors were also performed, and for eight of the 12 measurements, such equations are presented.


It is possible to obtain more highly individualized reference values for these cardiac dimensions, which may clinically be a better way of distinguishing pathological states from normal states.


aortic root; atrium; chamber; dimensions; left ventricle; wall thickness

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