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Comparison of Accuracy of Left Atrial Area and Volume by Two-dimensional Trans-thoracic Echocardiography Versus Computed Tomography

Title
Comparison of Accuracy of Left Atrial Area and Volume by Two-dimensional Trans-thoracic Echocardiography Versus Computed Tomography
Author
허란
Keywords
CHAMBER QUANTIFICATION; EUROPEAN-ASSOCIATION; AMERICAN-SOCIETY; SIZE; UNDERESTIMATION; RECOMMENDATIONS; PREDICTORS; STROKE
Issue Date
2019-04
Publisher
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
Citation
AMERICAN JOURNAL OF CARDIOLOGY, v. 123, NO 7, Page. 1180-1184
Abstract
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.
URI
https://www.sciencedirect.com/science/article/pii/S0002914919300542?via%3Dihubhttps://repository.hanyang.ac.kr/handle/20.500.11754/151109
ISSN
0002-9149; 1879-1913
DOI
10.1016/j.amjcard.2018.12.047
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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