Comparison of Accuracy of Left Atrial Area and Volume by Two-dimensional Trans-thoracic Echocardiography Versus Computed Tomography.
The American Journal of Cardiology(2019)
摘要
Left atrial (LA) size is prognostic of cardiovascular events and can be quantified as diameter, area, or volume. While LA area measurement by 2-dimensional (2D) echocardiography is performed by tracing LA borders in the apical 4-chamber view, LA volume is derived from a formula that is based on geometrical assumptions. We compared LA area and volume measurements obtained by trans-thoracic echocardiography (TTE) to those obtained using multi-detector computed tomography (MDCT). Sixty-four patients with MDCT and TTE performed within a 1-week period were included in the study. End-systolic LA area was planimetered from the 4-chamber view by TTE and MDCT. LA end systolic volume was calculated using the biplane area-length (AL) method in both TTE and MDCT. Mean LA volume measurement using MDCT was significantly larger than TTE measurement (92 +/- 31 mL vs 68 +/- 27 mL, p<0.001). There was moderate correlation between MDCT and TTE in both LA area (0.74, p<0.0001), and volumetric measurements (0.77, p<0.0001). Bland-Altman agreement plots demonstrated a significantly lower bias and narrower 95% confidence intervals (CI) for the 2D area (bias: -5.5; 95% CI: -14.3 to 3.3) as compared with volumetric measurements (bias: -23.7; 95% CI: -64.9 to 17.5, p<0.0001). Contrary to current guidelines for chamber quantification, 2D TTE LA area has better agreement with MDCT than volumetric measurements by TTE. LA volumetric measurements are desirable; however, they are currently less reliable than the direct LA area tracing by 2D TTE and therefore represent a suboptimal and less reproducible method to determine LA size. (C) 2019 Elsevier Inc. All rights reserved.
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