title: Repeatability and agreement of real time three-dimensional echocardiography measurements of left ventricular mass and synchrony in young patients.
abstract: BACKGROUND
  Left ventricular mass (LVM) and synchrony have prognostic value for many cardiovascular disease states. We report the agreement and repeatability of LVM estimation by three-dimensional (3D) versus M-mode and repeatability of 3D estimation of systolic dyssynchrony.
  
  
  METHODS
  3DLVM was computed by subtraction of endocardial from epicardial volume X1.05 both at end-diastole and end-systole. M-mode measurements were made at end-diastole. This prospective study comprised 40 subjects, 20 patients with chronic kidney disease or treated neuroblastoma and 20 healthy individuals. The median age was 17 (range 6-29 years).
  
  
  RESULTS
  Intra- and inter-observer intraclass correlation was excellent for 3D systolic LVM (0.99, 0.87), 3D diastolic LVM (0.99, 0.93), M-mode LVM (0.88, 0.93), moderate for 16-segment SDI (0.77, 062), moderate to low for 12-segment SDI (0.48, 0.73), and 6-segment SDI (0.37, 0.69). The median (range) LVM measurement for 3D diastolic LVM was 125 g (50-253), 3D systolic LVM 109 g (40-195), and M-mode LVM 115 g (range 40-207). There was a significant bias for diastolic 3DLVM to be higher than systolic 3D or M-mode. Limits of agreement between methods were wide. The median (range) systolic dyssynchrony measurements were 2.0 (0.4-7.0), 1.5 (0.3-4.3), and 1.4 (0.3-4.5) for 16-segment, 12-segment, and 6-segment models, respectively.
  
  
  CONCLUSIONS
  3D and M-mode measurement of LVM are highly repeatable. Measurement bias and wide limits of agreement mean that the same echocardiographic technique should be used during follow-up. Measurement of 3D systolic dyssynchrony is most repeatable using a 16-segment model.
authors: Department of Pediatric Cardiology, Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
authors: Tiina
authors: T
authors: Ojala
authors: Sujeev
authors: S
authors: Mathur
authors: Anu
authors: A
authors: Vatanen
authors: Manish D
authors: MD
authors: Sinha
authors: Kirsi
authors: K
authors: Jahnukainen
authors: John
authors: J
authors: Simpson
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003199:Computer Systems; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D015588:Observer Variation; D009929:Organ Size; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: left ventricular mass; synchrony; three-dimensional echocardiography