What determines echogenicity in a general population? The Tromso study

Background: It is widely recognized that in some people it is difficult or Impossible to acquire adequate measurements of cardiac performance and anat omy by any echocardiographic technique. We used our population-based screen ing to determine the characteristics of such unmeasurable subjects. Method: In a sample of 3287 subjects aged 25 to 85 years, we used standard 2-dimensional guided M-mode echocardiography and pulsed and color Doppler t o assess left ventricular (LV) structure and function. Results: Of 3287 subjects only 0.4% could not be measured. by any technique . In 2794 subjects M-mode registrations of good quality were obtained, whic h allowed calculation of LV mass and LV ejection fraction. Those in whom me asurements could not be obtained had a significantly higher age, body mass index, blood pressure, waist/hip ratio, and were more likely to smoke, be a man, be taking antihypertensive medication, have a history of ischemic hea rt disease, and have a low level of physical activity. Conclusion: Because subjects with high cardiovascular risk factor levels ar e less likely to be measurable with echocardiography, a need exists for oth er noninvasive diagnostic methods in these persons.