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Echocardiographic Evaluation of Normal Adult Left Ventricular Geometry in a Nigerian Population

Ugwuanyi DC, Eze CU, Nwagbara CT, Chiegwu HU, Eze JC and Ogolodom MP

Background: Recent studies have shown that nearly 50% of patients who die suddenly at any age and of either sex in Nigeria are affected by cardiomyopathies. Differences have shown to exist in some echocardiographic measurements that were attributed to racial, ethnic and gender. There is paucity of literature on the normal adult left ventricular geometryin our locality. Objective: To determine echocardiographic baseline data of normal adult left ventricular (LV) geometry in Nnewi community setting of Anambra state, Nigeria. Methods: This was a prospective cross-sectional study, in which 1,192 apparently healthy adult subjects were selected randomdly. Participants below the age of 18 years or those with congenital or acquired cardiac abnormalities and history of long-term regular physical training were excluded from the study. Ethical approval and informed consent were obtained for study. The study was conducted between March 2017 and August 2019. Trans-thoracic echocardiography was performed with Vivid T8 GE dedicated echocardiography machine with probe frequency of 1.7 to 3.2 MHz with integrated electrocardiography (ECG) recording electrodes. The study determined normal dimensions of interventricular septum (IVS), left ventricular internal diameter (LVIDd/LVIDs), and left ventricular posterior wall (LVPW) in diastole and systole of the included subjects. Both descriptive statistics and inferential statistics (Pearson’s correlation and regression analysis and the t-test for two samples assuming equal variance analysis) were used statistical analysis. Statistical value less than 0.05 was considered significant. All measurements were indexed to body surface area (BSA) to obtain echocardiographic baseline normal reference values. Results: The mean + SD values of LV parameters were: LVIDd (44.80 ± 5.71 mm vs.42.75 ± 5.21 mm), LVIDs (33.54 ± 5.37 mm vs.30.38 ± 4.81 mm), and LVPWd (8.32 ± 1.26 mm vs.7.51 ± 1.22 mm). Females had more statistically significant interventricular septum in diastole (IVSd) (8.20 ± 1.38 mm vs.7.05 ± 1.27 mm) and interventricular septum in systole (IVSs) (9.08 ± 1.42 mm vs.8.99 ± 1.33 mm) (P<0.05). A linear relationship existed between all echocardiographic measurements with age (r=0.017), height (r=0.009), weight (r=0.122), BMI (r=0.120) and BSA (r=0.109). Conclusion: This research established echocardiographic baseline normal adult left ventricular geometryin the study population.