• Deepak Borde, Kumar Chidambaram, Ayya Syama Sundar, Venugopal Kulkarni, Amish Jasapara, Vijay Shetty, Ramachandra Gopinath, Archana Pathy, V V Raja Viswanath, Balaji Asegaonkar, Pramod Apsingkar, Unmesh Takalkar, Shreedhar Joshi, and Murali Chakravarthy.
• Department of Cardiac Anesthesia, Ozone Anesthesia Group, Aurangabad, Maharashtra, India. Electronic address: deepakborde2482@gmail.com.
• J. Cardiothorac. Vasc. Anesth. 2022 Jan 1; 36 (1): 184-194.

ObjectivesInformation on normative reference values for cardiac structures is critical for the accurate application of echocardiography for guiding clinical decision-making. Many studies using transthoracic echocardiography (TTE) have shown that Indians have smaller diameters of various cardiac structures. There are no normative studies for transesophageal echocardiography (TEE). The authors observed dimensions of various cardiac structures in healthy Indian patients under general anesthesia using TEE and compared them with existing guidelines from non-Indian data.DesignThe Indian Normative TEE Measurements study was a multicenter, prospective observational study conducted in India.SettingOperating rooms for noncardiac surgeries in tertiary care-level hospitals.ParticipantsAdult patients undergoing noncardiac surgery who were free from any cardiac, respiratory, and renal diseases and had no contraindications for TEE.InterventionsAfter inducing general anesthesia and achieving stable hemodynamic conditions, a comprehensive TEE examination was performed and various measurements were made.Measurements And Main ResultsFor each of the 83 patients undergoing noncardiac surgery, 39 various measurements for left ventricle, right ventricle, both atria, and all valves were made. This included diameters and functional parameters. They were analyzed in a vendor-neutral software off-line. The absolute values of many of the measurements were higher in men, but when indexed to body surface area (BSA) they were similar in both sexes. The values were lower than most of the Western data but matched previous Indian studies using TTE.ConclusionsThe authors present normative values of various echocardiographic parameters using TEE. Because of its variations, it is recommended to use India-specific data to make decisions in Indian patients. It may be prudent to use BSA-indexed values during decision-making.Copyright © 2021 Elsevier Inc. All rights reserved.

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