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- Title
Best Method for Right Atrial Volume Assessment by Two-Dimensional Echocardiography: Validation with Magnetic Resonance Imaging.
- Authors
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.
- Abstract
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 Simpson's method of disks ( Simpson's). Echocardiographic RA volumes as well as linear RA major and minor dimensions were compared to RA volume by MRI using correlation and Bland- Altman methods, and evaluated for inter-observer reproducibility and accuracy in discriminating RA enlargement. All echocardiography volumetric methods performed well compared to MRI, with Pearson'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/m2, limits of agreement ±9.8 mL/m2) and Simpson's (bias −5.15 mL/m2, limits of agreement ±10.1 mL/m2) outperformed biplane 4C-subcostal (bias −8.36 mL/m2, limits of agreement ±12.5 mL/m2). 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 Simpson's are highly accurate and reproducible 2D echocardiography methods for estimating RA volume. Linear dimensions are inaccurate and should be abandoned.
- Subjects
RIGHT heart atrium; CONFIDENCE intervals; STATISTICAL correlation; DOPPLER echocardiography; MAGNETIC resonance imaging; RECEIVER operating characteristic curves; DESCRIPTIVE statistics; PHYSIOLOGY
- Publication
Echocardiography, 2015, Vol 32, Issue 5, p734
- ISSN
0742-2822
- Publication type
Article
- DOI
10.1111/echo.12735