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Evaluation of Left Atrial Size in Patients with Atrial Arrhythmias: Comparison of Standard 2D Versus Real Time 3D Echocardiography
Author(s) -
Müller Hajo,
Burri Haran,
Shah Dipen,
Lerch René
Publication year - 2007
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/j.1540-8175.2007.00495.x
Subject(s) - biplane , medicine , long axis , reproducibility , nuclear medicine , volume (thermodynamics) , cardiology , parasternal line , mathematics , geometry , materials science , physics , statistics , quantum mechanics , composite material
Aim: Two‐dimensional echocardiography may not correctly indicate size in nonspherical atria. The present study compares different parameters of left atrial size evaluated by standard two‐dimensional echocardiography with left atrial volume measured using three‐dimensional echocardiography (3DE). Methods and results: One hundred seventy consecutive patients with a history of atrial arrhythmias were studied by standard two‐dimensional and by real time 3DE. Of these 166 (98%) recordings were of sufficient quality for interpretation by both imaging techniques. The following parameters of left atrial size were measured: parasternal long axis diameter (PLAX), apical 4‐chamber short‐axis diameter (4CH short axis), apical 4‐chamber (4CH long axis), and 2‐chamber long‐axis diameters and planimetry areas. Two‐dimensional‐derived left atrial volumes were calculated by using both single plane (4CH area‐length) and biplane area‐length methods. The 2D parameters were then correlated with left atrial volume measured by 3D echocardiography. Linear regression analysis showed moderate correlation for 4‐chamber planimetry area (r = 0.76, P < 0.0001) and 2D‐derived volume calculations (r of 4CH single plane area‐length LA volume = 0.74 and biplane area‐length LA volume = 0.78, P < 0.0001). Diameters correlated less well with 3DE volume (r of PLAX = 0.67, 4CH short axis = 0.68, 4CH long axis = 0.63, P < 0.0001 respectively). Conclusion: The results demonstrate that measurements of dimensions using standard echocardiography are of limited accuracy to assess left atrial volume. If 3DE is not available, 4‐chamber planimetry area is a valid simple parameter for evaluating left atrial size in clinical practice. Two‐dimensional‐derived volume by biplane area‐length method was only slightly better correlated with 3DE volume than 4‐chamber planimetry area.