Determinants of discrepancies between two-dimensional echocardiographic methods for assessment of maximal left atrial volume
| Autor: | Sergio Mondillo, Giovanni M. Santoro, Stefano Nistri, Andrea Rossi, Alfredo Zuppiroli, Maurizio Galderisi, Antonello D'Andrea, Federico Gentile, Maria Angela Losi, Piercarlo Ballo, Iacopo Olivotto, Donato Mele, Frank Lloyd Dini |
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| Přispěvatelé: | Ballo, Piercarlo, Nistri, Stefano, Galderisi, Maurizio, Mele, Donato, Rossi, Andrea, Dini, Frank L, Olivotto, Iacopo, Losi, MARIA ANGELA, D'Andrea, Antonello, Zuppiroli, Alfredo, Santoro, Giovanni Maria, Mondillo, Sergio, Gentile, Federico |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Study groups Population Left atrium 030204 cardiovascular system & hematology Biplane 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Reference Values Left atrial medicine Humans Radiology Nuclear Medicine and imaging Left atrial volume Heart Atria education Aged Analysis of Variance Reproducibility education.field_of_study business.industry Organ Size General Medicine Repeatability Middle Aged Left atrial geometry Echocardiography medicine.anatomical_structure Athletes Case-Control Studies Hypertension Atrial Function Left Female Cardiology and Cardiovascular Medicine Nuclear medicine business Body mass index |
| Popis: | Aims The determinants of discrepancies among two-dimensional echocardiographic (2D-E) methods for left atrial volume (LAV) assessment are poorly investigated. Methods and results Maximal LAV was measured in 613 individuals (282 healthy subjects,180 athletes, and 151 hypertensives; age 45 ± 20 years, 62% male) using the ellipsoid model (LAVEllips), the area–length method (LAVAL), and the Simpson's rule (LAVSimps). On the basis of a mathematical model, two left atrial (LA) geometry indexes were tested as predictors of discrepancies between methods: the ratio between LA medial–lateral diameter (MLD) and LA anteroposterior diameter (APD); and the ratio between LA area in the four-chamber view and that of an ellipse with the same diameters [deviation from ellipse (DE)-coefficient]. Discrepancies among methods were consistently present in the overall population and across all study groups. MLD/APD and the DE-coefficient together predicted 76 and 68% of differences between biplane LAVAL and LAVEllips, and between biplane LAVSimps and LAVEllips, respectively. The DE-coefficient was the only determinant of LAVAL/LAVSimps difference ( β = 0.167, P < 0.0001). Body mass index was the strongest predictor of discrepancies between single-plane and biplane approaches of LAVAL ( β = 0.427, P < 0.0001) and LAVSimps ( β = 0.424, P < 0.0001). In additional analyses, biplane LAVAL showed the best agreement with LAV obtained by three-dimensional echocardiography and the best reproducibility and repeatability. Conclusion LA geometry is the main determinant of inconsistencies between 2D-E methods for measuring maximal LAV. Body mass index is the strongest determinant of differences between single-plane and biplane approaches. Different 2D-E methods cannot be used interchangeably for diagnosis and follow-up. The biplane area–length method should be preferred, particularly in overweight-obese subjects. |
| Databáze: | OpenAIRE |
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