title: Accuracy of echocardiographic area-length method in chronic myocardial infarction: comparison with cardiac CT in pigs.
abstract: BACKGROUND
  We evaluated echocardiographic area-length methods to measure left ventricle (LV) volumes and ejection fraction (EF) in parasternal short axis views in comparison with cardiac computed tomography (CT) in pigs with chronic myocardial infarction (MI).
  
  
  METHODS
  Male farm pigs with surgical occlusion of the left anterior descending coronary artery (n = 9) or sham operation (n = 5) had transthoracic echocardiography and cardiac-CT 3 months after surgery. We measured length of the LV in parasternal long axis view, and both systolic and diastolic LV areas in parasternal short axis views at the level of mitral valve, papillary muscles and apex. Volumes and EF of the LV were calculated using Simpson's method of discs (tri-plane area) or Cylinder-hemiellipsoid method (single plane area).
  
  
  RESULTS
  The pigs with coronary occlusion had anterior MI scars and reduced EF (average EF 42 ± 10%) by CT. Measurements of LV volumes and EF were reproducible by echocardiography. Compared with CT, end-diastolic volume (EDV) measured by echocardiography showed good correlation and agreement using either Simpson's method (r = 0.90; mean difference -2, 95% CI -47 to 43 mL) or Cylinder-hemiellipsoid method (r = 0.94; mean difference 3, 95% CI -44 to 49 mL). Furthermore, End-systolic volume (ESV) measured by echocardiography showed also good correlation and agreement using either Simpson's method (r = 0.94; mean difference 12 ml, 95% CI: -16 to 40) or Cylinder-hemiellipsoid method (r = 0.97; mean difference:13 ml, 95% CI: -8 to 33). EF was underestimated using either Simpson's method (r = 0.78; mean difference -6, 95% CI -11 to 1%) or Cylinder-hemiellipsoid method (r = 0.74; mean difference -4, 95% CI-10 to 2%).
  
  
  CONCLUSIONS
  Our results indicate that measurement of LV volumes may be accurate, but EF is underestimated using either three or single parasternal short axis planes by echocardiography in a large animal model of chronic MI.
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, Turku, 20520, Finland. Haitham.Ballo@utu.fi.|Heart Center, Turku University Hospital and University of Turku, Turku, Finland. Haitham.Ballo@utu.fi.
authors.forename: Haitham
authors.identifier: http://orcid.org/0000-0002-1104-7125
authors.initials: H
authors.lastname: Ballo
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, Turku, 20520, Finland.
authors.forename: Miikka
authors.initials: M
authors.lastname: Tarkia
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, Turku, 20520, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Haavisto
authors.affiliation: Heart Center, Turku University Hospital and University of Turku, Turku, Finland.|Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
authors.forename: Christoffer
authors.initials: C
authors.lastname: Stark
authors.affiliation: Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Marjatta
authors.initials: M
authors.lastname: Strandberg
authors.affiliation: Heart Center, Turku University Hospital and University of Turku, Turku, Finland.|Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
authors.forename: Tommi
authors.initials: T
authors.lastname: Vähäsilta
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, Turku, 20520, Finland.
authors.forename: Virva
authors.initials: V
authors.lastname: Saunavaara
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, Turku, 20520, Finland.
authors.forename: Tuula
authors.initials: T
authors.lastname: Tolvanen
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, Turku, 20520, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Teräs
authors.affiliation: Department of Anesthesiology, Intensive Care, Emergency Care and Pain Medicine, Turku University Hospital, Turku, Finland.
authors.forename: Ville-Veikko
authors.initials: VV
authors.lastname: Hynninen
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Savunen
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, Turku, 20520, Finland.|Turku Center for Disease Modeling, University of Turku, Turku, Finland.
authors.forename: Anne
authors.initials: A
authors.lastname: Roivainen
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, Turku, 20520, Finland.
authors.forename: Juhani
authors.initials: J
authors.lastname: Knuuti
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, Turku, 20520, Finland.|Heart Center, Turku University Hospital and University of Turku, Turku, Finland.|Institute of Clinical Medicine, University of Turku, Turku, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Saraste
mesh_terms: D000818:Animals; D002908:Chronic Disease; D004195:Disease Models, Animal; D004452:Echocardiography / Q000379:methods*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis*; D015203:Reproducibility of Results; D013552:Swine; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Cardiac CT; Ejection fraction; Transthoracic echocardiography