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- Title
Assessment of Echocardiographic Left Atrial Size: Accuracy of M-Mode and Two-Dimensional Methods and Prediction of Diastolic Dysfunction.
- Authors
Stefano, Gregory T.; Zhao, Hong; Schluchter, Mark; Hoit, Brian D.
- Abstract
Background: Despite the American Society of Echocardiography recommendation to use left atrial volume indexed for body surface area (LAVI) for quantification of left atrial size, a variety of methods are used in clinical practice. Our objectives were to evaluate the accuracy of M-mode and two-dimensional (2D) echocardiographic LA size estimates to LAVI and to determine their ability to predict left ventricular diastolic dysfunction. Methods: In 150 consecutive patients, LA diameter (LAD), LA diameter indexed for body surface area (LADI), LA area in the apical two- and four-chamber views (LAA 2c and LAA 4c), biplane area-length LA volume (LAV), and LAVI were obtained. The accuracy of these methods to quantify LA enlargement by LAVI, correlation with clinical parameters, and ability to act as a surrogate for diastolic dysfunction were determined using Pearson correlation coefficients along with univariate and multiple logistic analysis. Results: The true degree of LA size (with LAVI as standard) was identified by LAD in 45%, LADI in 42%, LAA 4c in 43%, and LAA 2c in 41%. All methods showed positive correlation with age, E/E′, mitral regurgitation, and right atrial size and negative correlation with ejection fraction. LAVI was the strongest method to predict any (c = 0.655, P = 0.012) or moderate-severe (P = 0.856 and P < 0.001) diastolic dysfunction. All methods have greater capacity to identify moderate or severe diastolic dysfunction than any degree of diastolic dysfunction alone. Conclusions: One-dimensional and 2D methods inaccurately quantify LA size and are inferior to LAVI to predict diastolic dysfunction. (Echocardiography 2012;29:379-384)
- Subjects
HEART ventricle diseases; LEFT heart ventricle; RISK assessment; HEART atrium; AGE distribution; CARDIAC output; COMPARATIVE studies; CONFIDENCE intervals; CONGENITAL heart disease; STATISTICAL correlation; DIASTOLE (Cardiac cycle); DOPPLER echocardiography; ECHOCARDIOGRAPHY; HEART beat; MITRAL valve insufficiency; STATISTICS; U-statistics; DATA analysis; MULTIPLE regression analysis; PREDICTIVE validity; INTER-observer reliability; DATA analysis software; DESCRIPTIVE statistics; ANATOMY; DIAGNOSIS
- Publication
Echocardiography, 2012, Vol 29, Issue 4, p379
- ISSN
0742-2822
- Publication type
Article
- DOI
10.1111/j.1540-8175.2011.01643.x