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

Figure 1. (a) A two-dimensionally guided measurement of LV wall thickness in end-diastole from the left parasternal long-axis view. The interventricular septum thickness (white arrow), LV end-diastolic diameter (red arrow), and the posterior wall (PW; yellow arrow) thickness are measured just distal to the mitral leaflets tips, perpendicular to the long axis of the LV. (b) Proximal LV outflow tract (LVOT) diameter was measured in mid-systole, using the trailing-edge-to leading-edge method, 0.5–1 cm below the aortic cusps in a plane parallel to the aortic annulus (white arrow) from the zoomed parasternal long-axis view. The yellow dashed arrow represents the distal LVOT diameter measured just below the aortic annulus level

Figure 2. Two-dimensional measurements of left ventricle (LV) volumes using the biplane method of discs (modified Simpson’s rule), in the apical four-chamber (A4C) and the apical two-chamber (A2C) views at end-diastole (LVEDV) and at end-systole (LVESV). LV trabeculations and the papillary muscles should be excluded from the cavity in the tracing

Figure 3. (a) Measurement of right ventricle (RV) linear dimensions from the apical four-chamber view showing the RV basal (RVD1) and mid-cavity (RVD2) dimensions and the RV longitudinal dimension (RVD3). Measurements were obtained at end-diastole. (b) Measurement of the RV end-diastolic area in the apical four-chamber view. The endocardial border is traced in the apical four-chamber views from the tricuspid annulus along the free RV wall to the apex, back to the tricuspid annulus, and along the interventricular septum. Care wastaken to enclose trabeculation, tricuspid leaflets, and chords in this area. (c) Measurement of the RV end-systolic area in the apical four-chamber view. The endocardial border is traced in apical four-chamber views from the tricuspid annulus along the free RV wall to the apex, back to the tricuspid annulus, along the interventricular septum. Care was taken to enclose trabeculation, tricuspid leaflets, and chords in this area

Figure 4. (a) Measurement of the left atrial diameter from the parasternal long-axis view at end-systole. Measurement is done from trailing-edge-to-leading-edge from the posterior aortic wall to the posterior aspect of the left atrial wall in a plane parallel to the mitral annulus. (b and c) Measurement of left atrial volume using Simpson’s biplane method from the apical four-chamber (A4C) and apical two-chamber (A2C) views at ventricular end-systole (maximum LA size). The LA length (L) is measured perpendicular from the mid-point of the segment that unifies the hinge points of the mitral leaflets, up to the ceiling of the LA. The LA minor dimension (d) is represented by a white line from the lateral wall to the interatrial septum. Care wastaken to exclude the pulmonary veins while tracing the LA. (d) Measurement of the right atrial (RA) area end-systole from the parasternal four-chamber view. The right atrial major dimension (L) is represented by the yellow line from the tricuspid annulus plane center to the superior RA wall, and the RA minor dimension (d) is represented by the white line from the anterolateral wall to the interatrial septum.

Figure 5. Intraclass correlation coefficient value is 0.986 (95% CI: 0.975–0.992; P<0.001)