Methods
Comparison Between Direct Volumetric and Speckle Tracking Methodologies for Left Ventricular and Left Atrial Chamber Quantification by Three-Dimensional Echocardiography

https://doi.org/10.1016/j.amjcard.2011.05.042Get rights and content

In an era of rapidly expanding and evolving 3-dimensional echocardiographic (3DE) technology, 1 of the issues facing the 3DE quantification of chamber volumes and function is that different software vendors use different methodologies and algorithms. The aim of this study was to evaluate the comparability and reproducibility of 3DE direct volumetric and speckle-tracking methods for left ventricular (LV) and left atrial (LA) chamber quantification. A total of 120 subjects (mean age 53 ± 17 years, 65% men), including 88 unselected patients and 32 healthy volunteers, underwent 3DE acquisitions and analysis using direct volumetric and speckle-tracking methods successively. Measurements of LV and LA volumes and LV function were compared between the 2 3DE methods. Additionally, intraobserver and interobserver reproducibility was assessed in 40 randomly selected patients. Measurements of LV end-diastolic volume, end-systolic volume, and ejection fraction by 3DE direct volumetric and 3DE speckle-tracking methods were comparable, with good correlations (r = 0.98, r = 0.98, and r = 0.87, respectively), small biases, and narrow limits of agreement (−1 ± 8 ml, −1 ± 8 ml, and 0 ± 6%, respectively). For measurements of LA end-systolic volume and end-diastolic volume, similar correlations (r = 0.96 for both), small biases, and narrow limits of agreement (−2 ± 6 and −1 ± 5 ml, respectively) were found between the 2 methods. Intraobserver and interobserver reproducibility for LV and LA quantification were comparable for the 2 methods. In conclusion, 3DE direct volumetric and speckle-tracking methods give comparable and reproducible quantification of LV and LA volumes and function, making interchangeable application a viable option in daily clinical practice.

Section snippets

Methods

A total of 120 subjects (mean age 53 ± 17 years, 65% men) were enrolled in this study, including 88 unselected patients in sinus rhythm with various diagnoses of heart disease and 32 healthy volunteers. Three-dimensional echocardiographic acquisitions of the left ventricle and left atrium were performed in all 120 subjects and in 105 of 120 subjects (mean age 54 ± 19 years, 66% men), respectively. After acquisition, 22 subjects (18%) were excluded from the LV analysis because of poor LV image

Results

Mean LV volumes and ejection fraction measured by 3DE direct volumetric and speckle-tracking methods were not significantly different. Excellent correlations were found between the 2 methods for all variables, and Bland-Altman analysis demonstrated small biases and relatively narrow limits of agreement (Figure 3).

Measurements of LA volumes by the 2 methods also correlated well and demonstrated narrow limits of agreement. Similar to LV volume measurements, LA volumes were generally somewhat

Discussion

In an era of rapidly expanding and evolving 3DE technology, 1 of the issues facing 3DE quantification of chamber volumes and function is that different software vendors use different methodologies and algorithms. This may result in different reference values and varying reproducibility between methods that ultimately may significantly affect their comparability in daily clinical practice. For the purpose of standardization, it is of critical importance to evaluate and compare the clinical

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