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Automated quantification of left atrial size using three-beat averaging real-time three dimensional Echocardiography in patients with atrial fibrillation.

Heo R, Hong GR, Kim YJ, Mancina J, Cho IJ, Shim CY, Chang HJ, Ha JW, Chung N - Cardiovasc Ultrasound (2015)

Bottom Line: However, 3BA-RT3DE demonstrated a small degree of underestimation (30.5 mL) of LA volume compared to 2DE-based measurements.Good-quality images from 3BA-RT3DE (n = 16) showed a significantly tighter correlation with images from CT scanning (R(2) = 0.60, p = 0.0004, ICC = 0.76, p < 0.001) compared to those of fair quality.An image of good quality is essential for maximizing the value of this method in clinical practice.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Background: Left atrial (LA) sizing in patients with atrial fibrillation (AF) is crucial for follow-up and outcome. Recently, the automated quantification of LA using the novel three-beat averaging real-time three dimensional echocardiography (3BA-RT3DE) is introduced. The aim of this study was to assess the feasibility and accuracy of 3BA-RT3DE in patients with atrial fibrillation (AF).

Methods: Thirty-one patients with AF (62.8 ± 11.7 years, 67.7 % male) were prospectively recruited to have two dimensional echocardiography (2DE) and 3BA-RT3DE (SC 2000, ACUSON, USA). The maximal left atrial (LA) volume was measured by the conventional prolate-ellipse (PE) and area-length (AL) method using three-beat averaging 2D transthoracic echocardiography and automated software analysis (eSie volume analysis, Siemens Medical Solution, Mountain view, USA); measurements were compared with those obtained by computed tomography (CT).

Results: Maximal LA volume by 3BA-RT3DE was feasible for all patients. LA volume was 68.4 ± 28.2 by PE-2DE, 89.2 ± 33.1 by AL-2DE, 100.6 ± 31.8 by 3BA-RT3DE, and 131.2 ± 42.2 mL by CT. LA volume from PE-2DE (R(2) = 0.48, p < 0.001, ICC = 0.64, p < 0.001), AL-2DE (R(2) = 0.47, p < 0.001, ICC = 0.67, p < 0.001), and 3BA-RT3DE (R(2) = 0.50, p = 0.001, ICC = 0.65, p < 0.001) showed significant correlations with CT. However, 3BA-RT3DE demonstrated a small degree of underestimation (30.5 mL) of LA volume compared to 2DE-based measurements. Good-quality images from 3BA-RT3DE (n = 16) showed a significantly tighter correlation with images from CT scanning (R(2) = 0.60, p = 0.0004, ICC = 0.76, p < 0.001) compared to those of fair quality.

Conclusion: Automated quantification of LA volume using 3BA-RT3DE is feasible and accurate in patients with AF. An image of good quality is essential for maximizing the value of this method in clinical practice.

No MeSH data available.


Related in: MedlinePlus

Relationship between measurements obtained by two-dimensional echocardiography (prolate-ellipse and area-length methods), three-beat averaging real-time three-dimensional echocardiography, and computed tomography. AL = area-length method, CT = computed tomography, LA = left atrium, PE = prolate-ellipse method, 3BA-RT3DE = three-beat averaging real-time three-dimensional echocardiography, 2DE = two dimensional echocardiography
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Fig3: Relationship between measurements obtained by two-dimensional echocardiography (prolate-ellipse and area-length methods), three-beat averaging real-time three-dimensional echocardiography, and computed tomography. AL = area-length method, CT = computed tomography, LA = left atrium, PE = prolate-ellipse method, 3BA-RT3DE = three-beat averaging real-time three-dimensional echocardiography, 2DE = two dimensional echocardiography

Mentions: The correlation between the maximal LA volume obtained from CT was fair with 2DE-based methods regardless of PE-2DE (R2 = 0.48, p < 0.001, ICC = 0.64, p < 0.001) or AL-2DE (R2 = 0.47, p < 0.001, ICC = 0.67, p < 0.001). The data from 3BA-RT3DE showed similar correlation (R2 = 0.50, p = 0.001, ICC = 0.68, p < 0.001) with measurements obtained by CT scan (Table 2, Fig. 3). The mean difference in the maximal LA volume measured by PE-2DE, AL-2DE, and 3BA-RT3DE and that from CT was 62.8, 41.9, and 30.5 mL, respectively. The limits of agreement for the 3BA-RT3DE were similar among echocardiography-based methods (1.96SD: 59.7 mL for PE-2DE, 60.8 for AL-2DE, 58.6 mL for 3BA-RT3DE). The difference between maximal LA volume by echocardiographic method and CT increased as the LA became enlarged. This trend was similar in 2DE and 3BA-RT3DE images (Fig. 3).Table 2


Automated quantification of left atrial size using three-beat averaging real-time three dimensional Echocardiography in patients with atrial fibrillation.

Heo R, Hong GR, Kim YJ, Mancina J, Cho IJ, Shim CY, Chang HJ, Ha JW, Chung N - Cardiovasc Ultrasound (2015)

Relationship between measurements obtained by two-dimensional echocardiography (prolate-ellipse and area-length methods), three-beat averaging real-time three-dimensional echocardiography, and computed tomography. AL = area-length method, CT = computed tomography, LA = left atrium, PE = prolate-ellipse method, 3BA-RT3DE = three-beat averaging real-time three-dimensional echocardiography, 2DE = two dimensional echocardiography
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4548448&req=5

Fig3: Relationship between measurements obtained by two-dimensional echocardiography (prolate-ellipse and area-length methods), three-beat averaging real-time three-dimensional echocardiography, and computed tomography. AL = area-length method, CT = computed tomography, LA = left atrium, PE = prolate-ellipse method, 3BA-RT3DE = three-beat averaging real-time three-dimensional echocardiography, 2DE = two dimensional echocardiography
Mentions: The correlation between the maximal LA volume obtained from CT was fair with 2DE-based methods regardless of PE-2DE (R2 = 0.48, p < 0.001, ICC = 0.64, p < 0.001) or AL-2DE (R2 = 0.47, p < 0.001, ICC = 0.67, p < 0.001). The data from 3BA-RT3DE showed similar correlation (R2 = 0.50, p = 0.001, ICC = 0.68, p < 0.001) with measurements obtained by CT scan (Table 2, Fig. 3). The mean difference in the maximal LA volume measured by PE-2DE, AL-2DE, and 3BA-RT3DE and that from CT was 62.8, 41.9, and 30.5 mL, respectively. The limits of agreement for the 3BA-RT3DE were similar among echocardiography-based methods (1.96SD: 59.7 mL for PE-2DE, 60.8 for AL-2DE, 58.6 mL for 3BA-RT3DE). The difference between maximal LA volume by echocardiographic method and CT increased as the LA became enlarged. This trend was similar in 2DE and 3BA-RT3DE images (Fig. 3).Table 2

Bottom Line: However, 3BA-RT3DE demonstrated a small degree of underestimation (30.5 mL) of LA volume compared to 2DE-based measurements.Good-quality images from 3BA-RT3DE (n = 16) showed a significantly tighter correlation with images from CT scanning (R(2) = 0.60, p = 0.0004, ICC = 0.76, p < 0.001) compared to those of fair quality.An image of good quality is essential for maximizing the value of this method in clinical practice.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Background: Left atrial (LA) sizing in patients with atrial fibrillation (AF) is crucial for follow-up and outcome. Recently, the automated quantification of LA using the novel three-beat averaging real-time three dimensional echocardiography (3BA-RT3DE) is introduced. The aim of this study was to assess the feasibility and accuracy of 3BA-RT3DE in patients with atrial fibrillation (AF).

Methods: Thirty-one patients with AF (62.8 ± 11.7 years, 67.7 % male) were prospectively recruited to have two dimensional echocardiography (2DE) and 3BA-RT3DE (SC 2000, ACUSON, USA). The maximal left atrial (LA) volume was measured by the conventional prolate-ellipse (PE) and area-length (AL) method using three-beat averaging 2D transthoracic echocardiography and automated software analysis (eSie volume analysis, Siemens Medical Solution, Mountain view, USA); measurements were compared with those obtained by computed tomography (CT).

Results: Maximal LA volume by 3BA-RT3DE was feasible for all patients. LA volume was 68.4 ± 28.2 by PE-2DE, 89.2 ± 33.1 by AL-2DE, 100.6 ± 31.8 by 3BA-RT3DE, and 131.2 ± 42.2 mL by CT. LA volume from PE-2DE (R(2) = 0.48, p < 0.001, ICC = 0.64, p < 0.001), AL-2DE (R(2) = 0.47, p < 0.001, ICC = 0.67, p < 0.001), and 3BA-RT3DE (R(2) = 0.50, p = 0.001, ICC = 0.65, p < 0.001) showed significant correlations with CT. However, 3BA-RT3DE demonstrated a small degree of underestimation (30.5 mL) of LA volume compared to 2DE-based measurements. Good-quality images from 3BA-RT3DE (n = 16) showed a significantly tighter correlation with images from CT scanning (R(2) = 0.60, p = 0.0004, ICC = 0.76, p < 0.001) compared to those of fair quality.

Conclusion: Automated quantification of LA volume using 3BA-RT3DE is feasible and accurate in patients with AF. An image of good quality is essential for maximizing the value of this method in clinical practice.

No MeSH data available.


Related in: MedlinePlus