Evidence map›Paper›PMID 32460308›Full record

SynthesisEuropean heart journal. Cardiovascular Imaging2021

Variation in left ventricular cardiac magnetic resonance normal reference ranges: systematic review and meta-analysis.

Zahra Raisi-Estabragh, Asmaa A M Kenawy, Nay Aung, Jackie Cooper, Patricia B Munroe, Nicholas C Harvey, Steffen E Petersen, Mohammed Y Khanji

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European heart journal. Cardiovascular Imaging, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.

  1. Society for Cardiovascular Magnetic Resonance reference values ("normal values") in cardiovascular magnetic resonance: 2025 update.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2025
    Guideline
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Certainties and Uncertainties of Cardiac Magnetic Resonance Imaging in Athletes.Journal of cardiovascular development and disease · 2022
    Review
  10. Article
  11. Article
  12. Article
  13. Article
  14. Redefining CMR reference standards through prognostic validation.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
    Article
  15. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Zahra Raisi-EstabraghWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
Asmaa A M KenawyWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
Nay AungWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
Jackie CooperWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
Patricia B MunroeWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
Nicholas C HarveyMRC Lifecourse Epidemiology Unit (MRCLEU), Tremona Rd, Southampton SO16 6YD, UK.
Steffen E PetersenWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
Mohammed Y KhanjiWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
St Bartholomew's Hospital · GBQueen Mary University of London · GBUniversity Hospital Southampton NHS Foundation Trust · GB

Funding

British Heart Foundation FS/17/81/33318Medical Research Council MC_PC_21003Wellcome Trust
6 · The paper itself

Abstract

aimsTo determine population-related and technical sources of variation in cardiac magnetic resonance (CMR) reference ranges for left ventricular (LV) quantification through a formal systematic review and meta-analysis. METHODS AND

resultsThis study is registered with the International Prospective Register of Systematic Reviews (CRD42019147161). Relevant studies were identified through electronic searches and assessed by two independent reviewers based on predefined criteria. Fifteen studies comprising 2132 women and 1890 men aged 20-91 years are included in the analysis. Pooled LV reference ranges calculated using random effects meta-analysis with inverse variance weighting revealed significant differences by age, sex, and ethnicity. Men had larger LV volumes and higher LV mass than women [LV end-diastolic volume (mean difference = 6.1 mL/m2, P-value = 0.014), LV end-systolic volume (MD = 4 mL/m2, P-value = 0.033), LV mass (mean difference = 12 g/m2, P-value = 7.8 × 10-9)]. Younger individuals had larger LV end-diastolic volumes than older ages (20-40 years vs. ≥65 years: women MD = 14.0 mL/m2, men MD = 14.7 mL/m2). East Asians (Chinese, Korean, Singaporean-Chinese, n = 514) had lower LV mass than Caucasians (women: MD = 6.4 g/m2, P-value = 0.016; men: MD = 9.8 g/m2, P-value = 6.7 × 10-5). Between-study heterogeneity was high for all LV parameters despite stratification by population-related factors. Sensitivity analyses identified differences in contouring methodology, magnet strength, and post-processing software as potential sources of heterogeneity.

conclusionThere is significant variation between CMR normal reference ranges due to multiple population-related and technical factors. Whilst there is need for population-stratified reference ranges, limited sample sizes and technical heterogeneity precludes derivation of meaningful unified ranges from existing reports. Wider representation of different populations and standardization of image analysis is urgently needed to establish such reference distributions.

Indexed as

Heart VentriclesVentricular Function, LeftAgedFemaleHeartHumansMagnetic Resonance SpectroscopyMaleMiddle AgedReference ValuesReproducibility of ResultsStroke Volumecardiac magnetic resonanceleft ventriclenormal rangereference range

Identifiers

PMID32460308
PMCPMC8081427
OpenAlexW3028802983

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.