Head-to-Head Comparison of Two-Dimensional and Three-Dimensional Echocardiographic Methods for Left Atrial Chamber Quantification with Magnetic Resonance Imaging

Buechel, Ronny R.; Stephan, F.; Sommer, Gregor; Bremerich, Jens; Zellweger, Michael J.; Kaufmann, Beat A.

doi:10.1016/j.echo.2013.01.001

Cited by 39 publications

(40 citation statements)

References 26 publications

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“…Compared with other modalities such as cardiac CT or magnetic resonance imaging (MRI), RT3DE is the most suited for measuring LA volumes and mechanical functions because it allows the assessment of phasic LA functional components and LA pathophysiology in various disease states. LA volumes derived from RT3DE show good agreement with CMR-derived volumes (9) and have a lower intraobserver variability than 2D echocardiography (18). LVDD is an expected finding in SSc patients, and it has been demonstrated in a number of studies with different techniques (19).…”

Section: Discussionmentioning

confidence: 76%

Evaluation of left atrial volume and function in systemic sclerosis patients using speckle tracking and real-time three-dimensional echocardiography

Atas

Kepez²,

Tigen³

et al. 2015

Anatol J Cardiol

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Objective:The aim of the present study was to evaluate left atrial (LA) volume and functions using real-time three-dimensional echocardiography (RT3DE) and speckle tracking in systemic sclerosis (SSc) patients.Methods:The study was designed as a cross-sectional observational study. We studied 41 consecutive SSc patients (38 females, mean age: 49.5±11.6 years) and 38 healthy controls (35 females, mean age: 48.5±10.8 years). Patients with evidence or history of cardiovascular disease and patients with risk factors as hypertension, diabetes and chronic renal failure were excluded from the study. All study subjects underwent standard echocardiography; LA speckle tracking and RT3DE was performed to assess LA volume and phasic functions. Differences between numeric variables were tested using the independent sample Student’s t-test or Mann-Whitney U test, where appropriate.Results:There were no significant differences between SSC patients and controls regarding left ventricular (LV) systolic functions and two-dimensional (2-D) atrial diameters. Presence of LV diastolic dysfunction (LVDD) was evaluated and graded according to recommendations of the American Society of Echocardiography. Accordingly, LVDD was observed to be significantly more frequent in SSc patients; 16 SSc patients (39%) and 5 controls (12.8%) were observed to have LVDD (p=0.007). With regard to results obtained from RT3DE, LA maximum, minimum, and before atrial contraction volumes were significantly higher (40.5±14.6 vs. 32.6±8.9, 15.5±8.4 vs. 9.9±3.5 and 28.7±11.7 vs. 21.4±7.0 mL respectively, p<0.05 for all), whereas LA active emptying fraction, LA total emptying fraction, LA expansion index, and passive emptying fraction values were significantly (47.1±12.0 vs. 52.9±10.1%, 62.8±10.5 vs. 69.5±6.7%, 187.5±76.0 vs. 246.6±96.0, 29.6±9.3 vs. 34.4±11.0% respectively, p<0.05 for all) in SSc patients than in controls. In addition, regarding results obtained from speckle tracking echocardiography, atrial peak-systolic longitudinal strain (e), early negative strain rate (SR), late negative SR, and peak positive SR values were observed to be significantly lower in SSc patients.Conclusion:LA volumes were significantly increased, and LA reservoir, conduit, and contractile functions were significantly impaired in SSc patients compared with controls. LA volume and functional analyses with RT3DE and speckle tracking may facilitate the recognition of subtle LA dysfunction in SSc patients.

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Section: Discussionmentioning

confidence: 76%

Evaluation of left atrial volume and function in systemic sclerosis patients using speckle tracking and real-time three-dimensional echocardiography

Atas

Kepez²,

Tigen³

et al. 2015

Anatol J Cardiol

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“…We also acknowledge that biplane 2D Echo is a widely accepted method to assess LA volume, but the unusual geometry of the atrium requires a number of geometric assumptions. Compared with MRI and 3D echo, 2D offers good correlation with modest volume underestimation across the cardiac cycle (6). As 3D Echo becomes more widely available, future studies should consider its use when quantifying LA volume.…”

Section: Discussionmentioning

confidence: 95%

Left atrial phasic function interacts to support left ventricular filling during exercise in healthy athletes

Wright

Sasson

Gray

et al. 2015

Journal of Applied Physiology

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We studied the contribution of phasic left atrial (LA) function to left ventricular (LV) filling during exercise. We hypothesized that reduced LV filling time at moderate-intensity exercise limits LA passive emptying and increases LA active emptying. Twenty endurance-trained males (55 ± 6 yr) were studied at rest and during light- (∼100 beats/min) and moderate-intensity (∼130 beats/min) exercise. Two-dimensional and Doppler echocardiography were used to assess phasic volumes and diastolic function. LV end-diastolic volume increased from rest to light exercise (54 ± 6 to 58 ± 5 ml/m(2), P < 0.01) and from light to moderate exercise (58 ± 5 to 62 ± 6 ml/m(2), P < 0.01). LA maximal volume increased from rest to light exercise (26 ± 4 to 30 ± 5 ml/m(2), P < 0.01) related to atrioventricular plane displacement (r = 0.55, P < 0.005), without further change at moderate exercise. LA passive emptying increased at light exercise (9 ± 2 to 13 ± 3 ml/m(2), P < 0.01) and then returned to baseline at moderate exercise, whereas LA active emptying increased appreciably only at moderate exercise (6 ± 2 to 14 ± 3 ml/m(2), P < 0.01). Thus, the total atrial emptying volume did not increase beyond light exercise, and the increase in LV filling at moderate exercise could be attributed primarily to an increase in the conduit flow volume (19 ± 3 to 25 ± 5 ml/m(2), P < 0.01). LA filling increases during exercise in relation to augmented LV longitudinal contraction. Conduit flow increases progressively with exercise in athletes, although this is driven by LV properties rather than intrinsic LA function. The pump function of the LA augments only at moderate exercise due to a reduced diastolic filling time and the Frank-Starling mechanism.

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“…Minimum LAVi may have better diagnostic power in early disease assessment [53]. Three-dimensional echocardiographic methods offer moderate improvement in accuracy at the cost of more elaborate analysis [54,55]; ellipse and cube methods should be avoided. Each method is reasonably reproducible, but they should not be used interchangeably for follow-up studies [56]; left atrial sphericity is a new independent predictor of recurrent atrial fibrillation [57].…”

Section: Measurement Of Left Atrial Sizementioning

confidence: 99%

Left atrial anatomy and physiology

Seward

Hebl²

2014

Current Opinion in Cardiology

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Head-to-Head Comparison of Two-Dimensional and Three-Dimensional Echocardiographic Methods for Left Atrial Chamber Quantification with Magnetic Resonance Imaging

Cited by 39 publications

References 26 publications

Evaluation of left atrial volume and function in systemic sclerosis patients using speckle tracking and real-time three-dimensional echocardiography

Evaluation of left atrial volume and function in systemic sclerosis patients using speckle tracking and real-time three-dimensional echocardiography

Left atrial phasic function interacts to support left ventricular filling during exercise in healthy athletes

Left atrial anatomy and physiology

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