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Best Method for Right Atrial Volume Assessment by Two‐Dimensional Echocardiography: Validation with Magnetic Resonance Imaging
Author(s) -
Ebtia Mahasti,
Murphy Darra,
Gin Kenneth,
Lee Pui K.,
Jue John,
Nair Parvathy,
Mayo John,
Barnes Marion E.,
Thompson Darby J. S.,
Tsang Teresa S. M.
Publication year - 2015
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12735
Subject(s) - biplane , reproducibility , medicine , limits of agreement , magnetic resonance imaging , concordance , bland–altman plot , concordance correlation coefficient , nuclear medicine , volume (thermodynamics) , correlation , radiology , mathematics , statistics , physics , quantum mechanics , engineering , aerospace engineering , geometry
Aim Echocardiographic methods for estimating right atrial ( RA ) volume have not been standardized. Our aim was to evaluate two‐dimensional (2D) echocardiographic methods of RA volume assessment, using RA volume by magnetic resonance imaging ( MRI ) as the reference. Methods and Results Right atrial volume was assessed in 51 patients (mean age 63 ± 14 years, 33 female) who underwent comprehensive 2D echocardiography and cardiac MRI for clinically indicated reasons. Echocardiographic RA volume methods included (1) biplane area length, using four‐chamber view twice (biplane 4C‐4C); (2) biplane area length, using four‐chamber and subcostal views (biplane 4C‐subcostal); and (3) single plane S impson's method of disks ( S impson's). Echocardiographic RA volumes as well as linear RA major and minor dimensions were compared to RA volume by MRI using correlation and B land– A ltman methods, and evaluated for inter‐observer reproducibility and accuracy in discriminating RA enlargement. All echocardiography volumetric methods performed well compared to MRI , with P earson's correlation of 0.98 and concordance correlation ≥0.91 for each. For bias and limits of agreement, biplane 4C‐4C (bias −4.81 mL/m 2 , limits of agreement ±9.8 mL/m 2 ) and S impson's (bias −5.15 mL/m 2 , limits of agreement ±10.1 mL/m 2 ) outperformed biplane 4C‐subcostal (bias −8.36 mL/m 2 , limits of agreement ±12.5 mL/m 2 ). Accuracy for discriminating RA enlargement was higher for all volumetric methods than for linear measurements. Inter‐observer variability was satisfactory across all methods. Conclusions Compared to MRI , biplane 4C‐4C and single plane S impson's are highly accurate and reproducible 2D echocardiography methods for estimating RA volume. Linear dimensions are inaccurate and should be abandoned.