Journal of the American Society of Echocardiography
Clinical InvestigationCardiac Chamber Volumes by EchocardiographyComparison of Echocardiographic Single-Plane versus Biplane Method in the Assessment of Left Atrial Volume and Validation by Real Time Three-Dimensional Echocardiography
Section snippets
Methods
The study was conducted at the Adult Cardiovascular Ultrasound Laboratories of Columbia University Medical Center. The study sample was derived from the National Institutes of Health–sponsored Cardiac Abnormalities and Brain Lesions (CABL) study, whose aim is to assess the relationship between cardiovascular subclinical disease and silent brain infarctions in a community-based cohort. Participants in CABL were drawn from the Northern Manhattan Study (NOMAS), an epidemiologic study carried out
Clinical Characteristics of the Study Sample
The study sample included 527 participants. The clinical characteristics are shown in Table 1. The mean age was 69.6 ± 9.7 years, and 61.9% were women. Hypertension was present in 68.5%, CAD in 5.9%, and atrial fibrillation in 2.1%. As expected, the large majority of the study participants were of Hispanic ethnic background (71.3%), with a minority of Caucasian (11.0%) and African American (14.2%) participants, reflecting the racial and ethnic composition of the community living in northern
Discussion
In our study, we compared echocardiographic single-plane LA volume determination with the biplane method. This is the first study to compare single-plane and biplane LA volume determination in a large population-based cohort and to explore the clinical reproducibility of the categorical agreement between the methods using current ASE cutoffs. The linear correlation between the biplane and the single-plane was excellent throughout the entire spectrum of LA volumes and was not affected by
Conclusions
This study shows that two-dimensional methods correlate well with 3D LA volume determination and that the single-plane method has a strong general correlation with the biplane method, suggesting its possible role as a simpler tool for measuring LA volume and its adequate accuracy when a biplane determination is not feasible. However, the frequent, albeit small, volume overestimation by the single-plane method results in a significant misclassification of patients when the ASE cutoffs are
Acknowledgments
We wish to thank Michele Alegre, RDCS, Rui Liu, MD, Janet DeRosa, MPH, and Rafi Cabral, MD, for their help in the collection of the data.
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This study was supported by grants R01 NS36286 (Marco R. Di Tullio, principal investigator) and NS29993 (Ralph L. Sacco, principal investigator) from the National Institute of Neurological Disorders and Stroke (Bethesda, MD).