Quantification of left atrial volumes using three-dimensional wall motion tracking echocardiographic technology: comparison with cardiac magnetic resonance.
BACKGROUND
Left atrium (LA) size assessment is clinically relevant, but the accuracy of two-dimensional echocardiographic (2D-echo) methods is limited. Three-dimensional (3D) echocardiography is an excellent alternative but is far from being used in daily clinical practice. Three-dimensional-wall motion tracking (3D-WMT) allows us to obtain volumes in a very simple and rapid manner. The aims of this study were to evaluate the accuracy of 3D-WMT technology to assess LA volume using cardiac magnetic resonance (CMR) as a reference method, to evaluate its reproducibility, and to determine its added clinical value to classify the LA enlargement severity.


RESULTS
Seventy consecutive patients referred for a CMR study were prospectively enrolled. They underwent LA volume assessment by means of 2D-echo, 3D-WMT, and CMR. Inter-methods agreement was assessed. The mean age was 56 ± 18 years and 42 patients (60%) were males. Average maximal LA volume obtained by 2D-echo, 3D-WMT, and CMR were 63.33 ± 26.82, 79.80 ± 29.0, and 79.80 ± 28.99 mL, respectively. Univariate linear regression analysis showed a good correlation between 3D-WMT and CMR (r = 0.83; P < 0.001). The agreement analysis showed a similar result (ICC = 0.83; 95% CI = 0.74-0.89; P < 0.001). Furthermore, the LA enlargement degree was better evaluated with 3D-WMT than with 2D-echo.


CONCLUSIONS
This study validates LA volume measurements obtained using the new and fast 3D-WMT technology, compared with CMR. This method is fast, accurate, and reproducible, and it allows a better classification of left LA enlargement severity compared with 2D-echo.
Cardiología Hospital Clínico San Carlos, Madrid, Spain Universidad Carlos III, Madrid, Spain leopisla@hotmail.com.
Leopoldo
L
Perez de Isla
Cardiología Hospital Clínico San Carlos, Madrid, Spain.
Gisela
G
Feltes
Cardiología Hospital Clínico San Carlos, Madrid, Spain.
Joel
J
Moreno
Cardiología Hospital Clínico San Carlos, Madrid, Spain.
Wilfredo
W
Martinez
Cardiología Hospital del Tajo, Aranjuez, Madrid, Spain.
Adriana
A
Saltijeral
Cardiología Hospital Clínico San Carlos, Madrid, Spain.
Jose A
JA
de Agustin
Cardiología Hospital Clínico San Carlos, Madrid, Spain.
Jose Juan
JJ
Gomez de Diego
Cardiología Hospital Clínico San Carlos, Madrid, Spain.
Pedro
P
Marcos-Alberca
Cardiología Hospital Clínico San Carlos, Madrid, Spain.
María
M
Luaces
Radiología, Hospital Clínico San Carlos, Madrid, Spain.
Joaquin
J
Ferreiros
Cardiología Hospital Clínico San Carlos, Madrid, Spain.
Miguel Angel
MA
Garcia Fernandez
Cardiología Hospital Clínico San Carlos, Madrid, Spain.
Carlos
C
Macaya
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016275:Atrial Function / Q000502:physiology; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D016014:Linear Models; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012737:Sex Factors
3D-wall motion tracking; Cardiac magnetic resonance; Left atrium; Three-dimensional echocardiography