Objectives
Information on normative reference values for cardiac structures is critical for the
accurate application of echocardiography for guiding clinical decision-making. Many
studies using transthoracic echocardiography (TTE) have shown that Indians have smaller
diameters of various cardiac structures. There are no normative studies for transesophageal
echocardiography (TEE). The authors observed dimensions of various cardiac structures
in healthy Indian patients under general anesthesia using TEE and compared them with
existing guidelines from non-Indian data.
Design
The Indian Normative TEE Measurements study was a multicenter, prospective observational
study conducted in India.
Setting
Operating rooms for noncardiac surgeries in tertiary care–level hospitals.
Participants
Adult patients undergoing noncardiac surgery who were free from any cardiac, respiratory,
and renal diseases and had no contraindications for TEE.
Interventions
After inducing general anesthesia and achieving stable hemodynamic conditions, a comprehensive
TEE examination was performed and various measurements were made.
Measurements and Main Results
For each of the 83 patients undergoing noncardiac surgery, 39 various measurements
for left ventricle, right ventricle, both atria, and all valves were made. This included
diameters and functional parameters. They were analyzed in a vendor-neutral software
off-line. The absolute values of many of the measurements were higher in men, but
when indexed to body surface area (BSA) they were similar in both sexes. The values
were lower than most of the Western data but matched previous Indian studies using
TTE.
Conclusions
The authors present normative values of various echocardiographic parameters using
TEE. Because of its variations, it is recommended to use India-specific data to make
decisions in Indian patients. It may be prudent to use BSA-indexed values during decision-making.
Key words
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Article info
Publication history
Published online: July 10, 2021
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