Cardiovascular magnetic resonance reference ranges from the Healthy Hearts Consortium
Cardiovascular magnetic resonance reference ranges from the Healthy Hearts Consortium
Background: The absence of population-stratified cardiovascular magnetic resonance (CMR) reference ranges from large cohorts is a major shortcoming for clinical care. Objectives: This paper provides age-, sex-, and ethnicity-specific CMR reference ranges for atrial and ventricular metrics from the Healthy Hearts Consortium, an international collaborative comprising 9,088 CMR studies from verified healthy individuals, covering the complete adult age spectrum across both sexes, and with the highest ethnic diversity reported to date. Methods: CMR studies were analyzed using certified software with batch processing capability (cvi42, version 5.14 prototype, Circle Cardiovascular Imaging) by 2 expert readers. Three segmentation methods (smooth, papillary, anatomic) were used to contour the endocardial and epicardial borders of the ventricles and atria from long- and short-axis cine series. Clinically established ventricular and atrial metrics were extracted and stratified by age, sex, and ethnicity. Variations by segmentation method, scanner vendor, and magnet strength were examined. Reference ranges are reported as 95% prediction intervals. Results: The sample included 4,452 (49.0%) men and 4,636 (51.0%) women with average age of 61.1 ± 12.9 years (range: 18-83 years). Among these, 7,424 (81.7%) were from White, 510 (5.6%) South Asian, 478 (5.3%) mixed/other, 341 (3.7%) Black, and 335 (3.7%) Chinese ethnicities. Images were acquired using 1.5-T (n = 8,779; 96.6%) and 3.0-T (n = 309; 3.4%) scanners from Siemens (n = 8,299; 91.3%), Philips (n = 498; 5.5%), and GE (n = 291, 3.2%). Conclusions: This work represents a resource with healthy CMR-derived volumetric reference ranges ready for clinical implementation.
artificial intelligence, automated analysis, cardiovascular magnetic resonance, ethnicity, healthy reference ranges, sex differences
746-762
Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a
Szabo, Liliana
a5da4e9d-450f-43e5-b2de-1b1cabde6a6c
McCracken, Celeste
5d772e9e-3aaa-41da-a5ef-3943b1631fd9
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
July 2024
Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a
Szabo, Liliana
a5da4e9d-450f-43e5-b2de-1b1cabde6a6c
McCracken, Celeste
5d772e9e-3aaa-41da-a5ef-3943b1631fd9
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Raisi-Estabragh, Zahra, Szabo, Liliana and McCracken, Celeste
,
et al.
(2024)
Cardiovascular magnetic resonance reference ranges from the Healthy Hearts Consortium.
JACC. Cardiovascular imaging, 17 (7), .
(doi:10.1016/j.jcmg.2024.01.009).
Abstract
Background: The absence of population-stratified cardiovascular magnetic resonance (CMR) reference ranges from large cohorts is a major shortcoming for clinical care. Objectives: This paper provides age-, sex-, and ethnicity-specific CMR reference ranges for atrial and ventricular metrics from the Healthy Hearts Consortium, an international collaborative comprising 9,088 CMR studies from verified healthy individuals, covering the complete adult age spectrum across both sexes, and with the highest ethnic diversity reported to date. Methods: CMR studies were analyzed using certified software with batch processing capability (cvi42, version 5.14 prototype, Circle Cardiovascular Imaging) by 2 expert readers. Three segmentation methods (smooth, papillary, anatomic) were used to contour the endocardial and epicardial borders of the ventricles and atria from long- and short-axis cine series. Clinically established ventricular and atrial metrics were extracted and stratified by age, sex, and ethnicity. Variations by segmentation method, scanner vendor, and magnet strength were examined. Reference ranges are reported as 95% prediction intervals. Results: The sample included 4,452 (49.0%) men and 4,636 (51.0%) women with average age of 61.1 ± 12.9 years (range: 18-83 years). Among these, 7,424 (81.7%) were from White, 510 (5.6%) South Asian, 478 (5.3%) mixed/other, 341 (3.7%) Black, and 335 (3.7%) Chinese ethnicities. Images were acquired using 1.5-T (n = 8,779; 96.6%) and 3.0-T (n = 309; 3.4%) scanners from Siemens (n = 8,299; 91.3%), Philips (n = 498; 5.5%), and GE (n = 291, 3.2%). Conclusions: This work represents a resource with healthy CMR-derived volumetric reference ranges ready for clinical implementation.
Text
Petersen-JIMG060523-0805_R1
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Accepted/In Press date: 19 January 2024
e-pub ahead of print date: 10 April 2024
Published date: July 2024
Additional Information:
Funding: ZRE recognizes the National Institute for Health and Care Research (NIHR) Integrated Academic Training programme which supports her Academic Clinical Lectureship post. LS was supported by the Barts Charity (G-002389). CM is supported by the Oxford NIHR Biomedical Research Centre (IS-BRC-1215-20008). AS was supported by the British Heart Foundation (PG/21/10619). DGC was supported by the Barts Charity (G-002530). This work acknowledges the support of the National Institute for Health and Care Research Barts Biomedical Research Centre (NIHR203330); a delivery partnership of Barts Health NHS Trust, Queen Mary University of London, St George’s University Hospitals NHS Foundation Trust and St George’s University of London. SEP and LS have received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 825903 (euCanSHare project). Barts Charity (G-002346) contributed to fees required to access UK Biobank data [access application #2964]. TL acknowledges support by The Netherlands Organization for Health Research and Development (ZonMW; grant number 90700432). NCH is supported by the UK Medical Research Council (MRC) [MC_PC_21003; MC_PC_21001], and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, UK.
Publisher Copyright:
© 2024 The Authors
Keywords:
artificial intelligence, automated analysis, cardiovascular magnetic resonance, ethnicity, healthy reference ranges, sex differences
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Local EPrints ID: 486521
URI: http://eprints.soton.ac.uk/id/eprint/486521
ISSN: 1876-7591
PURE UUID: cdcca325-de72-4c7c-be71-18856c903c97
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Date deposited: 25 Jan 2024 17:31
Last modified: 12 Jul 2024 01:42
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Author:
Zahra Raisi-Estabragh
Author:
Liliana Szabo
Author:
Celeste McCracken
Corporate Author: et al.
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