Should we quantify the diameters of the right heart in relation to the body surface area

Background: The evaluation of the right heart cavities represents a challenge for echocardiography, given the impossibility of their approach to a geometric model. Moreover, there are no recommendations on the need to adjust right heart dimensions to body surface area. Objective: The aim of this study was to establish the relationship between right heart chamber dimensions and body surface area in a population with no evidence of cardiopulmonary disease. Methods: The study included patients attending the echocardiography laboratory for a regular health examination. Patients with cardiac disease, right or left ventricular dysfunction, significant valve diseases, known pulmonary disease or pulmonary systolic pressure ≥45 mmHg were excluded from the study. Patients’ affiliation, weight (kg), height (meters), and body surface area (m2) data were recorded. Right heart measurements were based on guideline recommendations. The population was distributed in quartiles according to body surface area (25%-50%-75%-100%). Simple regression analysis was performed between each dimension of the right heart and body surface area. Results: A prospective, consecutive, observational and descriptive cohort study was performed including 1,045 patients with the following characteristics: mean age 41±15.1 years, 53% men, mean weight 77.4±19.6 kg, height 1.69±0.09 and BSA 1.89±0.87 m². Significant differences were observed in each of the variables according to the distribution by quartiles. A positive correlation was demonstrated between all right heart dimensions and body surface area. Conclusions: Body surface area is an important determinant of right heart dimensions measured by echocardiography. We therefore suggest the use of measurements indexed by body surface area, since it could influence clinical decision making.