Accuracy, analysis time, and reproducibility of dedicated 4D echocardiographic left atrial volume quantification software

Flemming Javier Olsen*, Litten Bertelsen, Niels Vejlstrup, Caroline Løkke Bjerregaard, Søren Zöga Diederichsen, Peter Godsk Jørgensen, Magnus T Jensen, Anders Dahl, Nino Emmanuel Landler, Claus Graff, Axel Brandes, Derk Krieger, Ketil Haugan, Lars Køber, Søren Højberg, Jesper Hastrup Svendsen, Tor Biering-Sørensen

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftArtikelForskningpeer review


Four-dimensional (4D) echocardiography may provide more accurate estimations of left atrial (LA) volumes than 2-dimensional (2D) measures. We sought to compare the concordance of a novel 4D LA quantification software versus 2D echocardiography against cardiac magnetic resonance (CMR). This was a multimodality imaging substudy of a randomized clinical trial (the LOOP study). Elderly participants with stroke risk factors were included. A subgroup of this study population underwent transthoracic echocardiography (n = 1441) and a subset underwent CMR within two weeks (n = 73). The mean age of the echocardiographic study population was 74 years and 54% were men. The maximal LA volume (LAVmax) was 47 mL by 2D, 52 mL by 4D, and 104 mL by CMR. While 2D echocardiography showed a moderate correlation with 4D (R2 = 0.51) it yielded significantly lower values for LAVmax with a mean difference of 4.5 ± 11.9 mL, p < 0.001. 4D echocardiography correlated strongly with CMR measurements (R2 = 0.70), whereas 2D echocardiography showed a moderate correlation (R2 = 0.53). However, both modalities systematically underestimated LAVmax largely compared to CMR (2D vs. CMR: - 54.9 ± 21.3 mL; 4D vs. CMR: - 49.7 ± 18.6 mL). Similar observations were made for minimal LA volume and LA volume before atrial contraction. Analyses time by 4D was shorter than for 2D (90 ± 11 vs. 118 ± 16 s, p < 0.001). Intra- and interobserver variability was lower for 4D than 2D. Four-dimensional echocardiography is faster, more reproducible, and correlates more closely to CMR than 2D echocardiography. Both 4D and 2D echocardiography systematically underestimates LA volumes compared to CMR, emphasizing that values of LA volumes are not interchangeable between echocardiography and CMR.

Sider (fra-til)1277-1288
TidsskriftInternational Journal of Cardiovascular Imaging
Udgave nummer6
Tidlig onlinedato3 jan. 2022
StatusUdgivet - jun. 2022

Bibliografisk note

© 2022. The Author(s), under exclusive licence to Springer Nature B.V.


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