AUTHOR=Wang Shitong , Wang Shuyu , Zhu Qing , Wang Yonghuai , Li Guangyuan , Kong Fanxin , Yang Jun , Ma Chunyan 

TITLE=Reference Values of Right Ventricular Volumes and Ejection Fraction by Three-Dimensional Echocardiography in Adults: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.709863

DOI=10.3389/fcvm.2021.709863

ISSN=2297-055X

ABSTRACT=Objective To determine the reference values for right ventricular (RV) volumes and ejection fraction (EF) using three-dimensional echocardiography (3DE) and to identify sources of variance through a systematic review and meta-analysis.
Methods This systematic review was pre-registered with the International Prospective Register of Systematic Reviews (CRD42020211002). Relevant studies were obtained by search of three databases, PubMed, Embase, and Cochrane Library, through October 2020. Pooled reference values were calculated using the random effects model weighted by inverse variance. Meta-regression analysis and Egger test were used to determine the source of heterogeneity. Subgroup analysis were performed to establish the reference values across different conditions.
Results The search identified 25 studies involving 2165 subjects. Pooled reference values were calculated using the random effects model weighted by inverse variance. The mean reference values were as follows: RV end-diastolic volume, 100.71 mL (95% confidence interval (CI), 90.92–110.51 mL); RV end-systolic volume, 44.19 mL (95% CI, 39.05–49.33 mL); RV end-diastolic volume indexed, 57.01 mL/m2 (95% CI, 51.93–62.08 mL/m2); RV end-systolic volume indexed, 25.41 mL/m2 (95% CI, 22.58–28.24 mL/m2); and RVEF, 56.20% (95% CI, 54.59%–57.82%). The gender- and age-specific reference values were defined according to the studies reporting the values of different genders and age distributions, respectively. In addition, the vendor- and software-specific reference values were determined. The meta-regression analysis revealed that gender, frame rate, and software packages were associated with variations in RV volumes (P < 0.05).
Conclusions This study determined the reference values for RV volumes and RVEF using 3DE in normal adults. Variations in the values of RV volumes across studies were significantly associated with the gender, frame rate, and software.