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Normal echocardiographic measurements in a Turkish population: The Healthy Heart ECHO-TR Trial [Anatol J Cardiol]
Anatol J Cardiol. 2019; 22(5): 262-270 | DOI: 10.14744/AnatolJCardiol.2019.45845  

Normal echocardiographic measurements in a Turkish population: The Healthy Heart ECHO-TR Trial

Özgen Şafak1, Ozan Mustafa Gürsoy2, Süleyman Karakoyun3, Metin Çağdaş3, Lale Dinç Asarcıklı4, Fulya Avcı Demir5, İbrahim Ersoy6, Abdurrahman Akyüz7, Özlem Arıcan Özlük8, Fahri Er8, Ahmet Oğuz Baktır9, Mahmut Yesin10, Hayati Eren11, Aylin Sungur12, Özge Kurmuş13, Volkan Emren14, Selcen Yakar Tülüce2, Filiz Akyıldız Akçay2, Mehmet Ata Akıl15, Tuba Makca16, Oktay Ergene17, Mehmet Özkan18
1Department Of Cardiology, Burdur State Hospital, Burdur, Turkey
2Department Of Cardiology, İzmir Atatürk Training And Research Hospital,i̇zmir, Turkey
3Department Of Cardiology, Kafkas University, Kars,Turkey
4Department Of Cardiology,Dr. Siyami Ersek Training And Research Hospital, İstanbul,Turkey
5Department of Cardiology,Elmalı State Hospital, Antalya, Turkey
6Department of Cardiology,Bucak State Hospital, Burdur,Turkey
7Department of Cardiology,Gazi Yaşargil Training and Research Hospital, Diyarbakır,Turkey
8Department of Cardiology, Yüksek İhtisas Training and Research Hospital, Bursa,Turkey
9Department of Cardiology, Kayseri Training and Research Hospital, Kayseri, Turkey
10Department of Cardiology,Kars State Hospital, Kars,Turkey
11Department of Cardiology, Elbistan State Hospital, Kahramanmaraş,Turkey
12Department of Cardiology,Kahramanmaraş Necip Fazıl State Hospiatl,Kahramanmaraş,Turkey
13Department of Cardiology,Ufuk University, Ankara, Turkey
14Department of Cardiology, Katip Çelebi University, İzmir,Turkey
15Department of Cardiology, Dicle University, Diyarbakır,Turkey
16Department of Cardiology, Adana Ceyhan State Hospital, Adana, Turkey
17Department of Cardiology, 9 Eylül University, İzmir,Turkey
18Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, İstanbul, Turkey

Objective: Normal reference values for the cardiac chambers are widely based on cohorts from European or American populations. In this study, we aimed to obtain normal echocardiographic measurements of healthy Turkish volunteers to reveal the age, gender, and geographical region dependent differences between Turkish populations and other populations.
Methods: Among 31 collaborating institutions from all regions of Turkey, 1154 healthy volunteers were enrolled in this study. Predefined protocols were used for all participants during echocardiographic examination. Blood biochemical parameters were also obtained for all patients on admission. The American Society of Echocardiography and European Association of Cardiovascular Imaging recommendations were used to assess the echocardiographic cardiac chamber quantification.
Results: The study included 1154 volunteers (men: 609; women: 545), with a mean age of 33.5±11 years. Compared to men, women had a smaller body surface area, lower blood pressure and heart rate, lower hemoglobin, total cholesterol, lower low-density lipoprotein (LDL) levels, and higher high density lipoprotein (HDL) levels. Cardiac chambers were also smaller in women and their size varied with age. When we compared the regions in Turkey, the lowest values of left cardiac chamber indices were seen in the Marmara region and the highest values were observed in the Mediterranean region. Regarding the right cardiac indices, the Mediterranean region reported the lowest values, while the Black Sea region and the Eastern Anatolia region reported the highest values.
Conclusion: This is the first study that evaluates the normal echocardiographic reference values for a healthy Turkish population. These results may provide important reference values that could be useful in routine clinical practice as well as in further clinical trials. (

Keywords: Echocardiography, left ventricle, left atrium, right ventricle, right atrium.


Özgen Şafak, Ozan Mustafa Gürsoy, Süleyman Karakoyun, Metin Çağdaş, Lale Dinç Asarcıklı, Fulya Avcı Demir, İbrahim Ersoy, Abdurrahman Akyüz, Özlem Arıcan Özlük, Fahri Er, Ahmet Oğuz Baktır, Mahmut Yesin, Hayati Eren, Aylin Sungur, Özge Kurmuş, Volkan Emren, Selcen Yakar Tülüce, Filiz Akyıldız Akçay, Mehmet Ata Akıl, Tuba Makca, Oktay Ergene, Mehmet Özkan. Normal echocardiographic measurements in a Turkish population: The Healthy Heart ECHO-TR Trial. Anatol J Cardiol. 2019; 22(5): 262-270

Corresponding Author: Özgen Şafak, Türkiye


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