Automated left atrial volume measurement by two-dimensional speckle-tracking echocardiography: feasibility, accuracy, and reproducibility

Florescu, Diana Ruxandra; Badano, Luigi P.; Tomaselli, Michele; Torlasco, Camilla; Târtea, Georgică Costinel; Bălşeanu, Tudor Adrian; Volpato, Valentina; Parati, Gianfranco; Muraru, Denisa

doi:10.1093/ehjci/jeab199

Cited by 16 publications

(14 citation statements)

References 27 publications

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“…RV end-diastolic and end-systolic volumes and ejection fraction (RVEF) were measured using a commercially available 3DE software package (4D RV Function 2.0 TomTec, Unterschleissheim, Germany) previously validated against CMR ( 18 ). RA maximal volume was measured with a commercially available 3DE software package designed for atrium quantification (4D Auto LAQ, GE Vingmed, Horten, Norway) previously described and validated against CMR ( 19 ). The methodology used for the 3DE acquisition of the TV and the analysis workflow of 4D AutoTVQ software have been detailed elsewhere ( https://gevividultraedition.com/storage/app/media/whitepapers/4D-Auto-TVQ-whitepaper-JB03442XX.pdf ).…”

Section: Methodsmentioning

confidence: 99%

Reference ranges of tricuspid annulus geometry in healthy adults using a dedicated three-dimensional echocardiography software package

Muraru

Gavazzoni

Heilbron

et al. 2022

Front. Cardiovasc. Med.

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BackgroundTricuspid annulus (TA) sizing is essential for planning percutaneous or surgical tricuspid procedures. According to current guidelines, TA linear dimension should be assessed using two-dimensional echocardiography (2DE). However, TA is a complex three-dimensional (3D) structure.AimIdentify the reference values for TA geometry and dynamics and its physiological determinants using a commercially available three-dimensional echocardiography (3DE) software package dedicated to the tricuspid valve (4D AutoTVQ, GE).MethodsA total of 254 healthy volunteers (113 men, 47 ± 11 years) were evaluated using 2DE and 3DE. TA 3D area, perimeter, diameters, and sphericity index were assessed at mid-systole, early- and end-diastole. Right atrial (RA) and ventricular (RV) end-diastolic and end-systolic volumes were also measured by 3DE.ResultsThe feasibility of the 3DE analysis of TA was 90%. TA 3D area, perimeter, and diameters were largest at end-diastole and smallest at mid-systole. Reference values of TA at end-diastole were 9.6 ± 2.1 cm2 for the area, 11.2 ± 1.2 cm for perimeter, and 38 ± 4 mm, 31 ± 4 mm, 33 ± 4 mm, and 34 ± 5 mm for major, minor, 4-chamber and 2-chamber diameters, respectively. TA end-diastolic sphericity index was 81 ± 11%. All TA parameters were correlated with body surface area (BSA) (r from 0.42 to 0.58, p < 0.001). TA 3D area and 4-chamber diameter were significantly larger in men than in women, independent of BSA (p < 0.0001). There was no significant relationship between TA metrics with age, except for the TA minor diameter (r = −0.17, p < 0.05). When measured by 2DE in 4-chamber (29 ± 5 mm) and RV-focused (30 ± 5 mm) views, both TA diameters resulted significantly smaller than the 4-chamber (33 ± 4 mm; p < 0.0001), and the major TA diameters (38 ± 4 mm; p < 0.0001) measured by 3DE. At multivariable linear regression analysis, RA maximal volume was independently associated with both TA 3D area at mid-systole (R2 = 0.511, p < 0.0001) and end-diastole (R2 = 0.506, p < 0.0001), whereas BSA (R2 = 0.526, p < 0.0001) was associated only to mid-systolic TA 3D area.ConclusionsReference values for TA metrics should be sex-specific and indexed to BSA. 2DE underestimates actual 3DE TA dimensions. RA maximum volume was the only independent echocardiographic parameter associated with TA 3D area in healthy subjects.

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Section: Methodsmentioning

confidence: 99%

Reference ranges of tricuspid annulus geometry in healthy adults using a dedicated three-dimensional echocardiography software package

Muraru

Gavazzoni

Heilbron

et al. 2022

Front. Cardiovasc. Med.

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“…Outcomes of interest included structural (left atrial volume index, LAVi) and functional (reservoir, conduit, and contractile atrial strains) measures of the left atrium. Maximal left atrial volume was measured before mitral valve opening using two-dimensional speckle tracking analysis of the left atrium, with four-and two-chamber apical views analyzed using AFI LA (GE EchoPAC), 12 and indexed to body surface area to calculate LAVi. Left atrial strain indices were calculated with speckle-tracking software with an autostrain algorithm (GE Echopac).…”

Section: Left Atrial Structure and Volumementioning

confidence: 99%

Associations of alcohol consumption with left atrial morphology and function in a population at high cardiovascular risk

Alam

Toledo

Romaguera

et al. 2023

Preprint

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BackgroundExcessive alcohol consumption has been associated with increased risk of atrial fibrillation, though the underlying mechanisms remain unclear. An enlarged left atrium and impaired left atrial function may lead to atrial fibrillation. The association of alcohol consumption with structural and functional left atrial measures, however, has received limited attention.MethodsWe studied a subset of 515 participants from the PREDIMED-Plus trial, a Spanish ongoing, multi-center randomized trial testing an intensive life weight loss intervention (ILI) with an energy reduced Mediterranean diet and physical activity promotion versus usual care andad libitumMediterranean diet recommendations for the primary prevention of cardiovascular disease in adults with the metabolic syndrome. Participants underwent transthoracic echocardiography (TTE) at baseline, year 3, and year 5 of the study. Outcomes of interest included volumetric (volume index) and functional (reservoir, conduit, and contractile strains) measures of the left atrium. Alcohol consumption was calculated through the use of validated food frequency questionnaires repeatedly collected every year and presented as drinks consumed per day (1 drink = 14 grams of alcohol). Confounder-adjusted multiple linear regression and mixed models were used to estimate the association of alcohol consumption (at baseline and over 5-years of follow-up) with left atrial volume and function at baseline and over the 5-year follow-up.ResultsMean alcohol consumption among 515 eligible participants (mean age: 65 years, 40% female) was 1.6 drinks/day. Cross-sectionally, higher alcohol consumption (modeled in 1 drink/day increases) was associated with larger left atrial volume (0.6 ml/m2, 95% CI 0.2, 1.1) and lower left atrial reservoir and contractile strain (-0.4%, 95% CI -0.8, 0.0, and -0.4, 95% CI -0.7, -0.1). Baseline alcohol consumption was not associated with changes in left atrial structure and function, but an increase in alcohol consumption (per 1 drink/day increase) during follow-up was associated with left atrial enlargement (0.7 mL/m2, 95% CI 0.2, 1.2) and, to a lesser extent, left atrial strain worsening (-0.3%, 95% CI -0.8, 0.2) over 5 years.ConclusionIn a population at high risk of cardiovascular disease, an increase of alcohol consumption was associated with left atrial volume enlargement and worsening atrial function, suggesting mechanistic information about potential pathways linking excessive alcohol consumption with atrial fibrillation risk.

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“…The main study outcomes were LA emptying fraction, LA longitudinal strain -relative change in length of the tissue segment compared to its original length-, indexed and maximum LA volume, LA conduit strain -deformation in length of the LA during the passive filling phase of the cardiac cycle-, pump strain -deformation in length of the LA contraction or active emptying phase of the cardiac cycle-, LA stiffness index -as a measures of LA compliance-, and LA function index -overall performance of the LA-. [16][17][18]…”

Section: Study Outcomesmentioning

confidence: 99%

Effect of an intensive lifestyle intervention on the structural and functional substrate for atrial fibrillation in people with metabolic syndrome

Rossello,

Ramallal,

Romaguera

et al. 2023

Preprint

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Aims. To evaluate the effect of an intensive lifestyle intervention (ILI) on the underlying structural and functional cardiac substrate of atrial fibrillation (AF) in overweight or obese people with metabolic syndrome (MetS). Methods. Participants of the PREDIMED-PLUS trial (n=6874) were randomised 1:1 to an ILI program based on an energy-reduced Mediterranean Diet, increased physical activity, and cognitive-behavioural weight management, or to a control intervention of low-intensity dietary advice. Transthoracic echocardiography (TTE) was evaluated in a subsample of 534 participants by a core lab at baseline, 3-year and 5-year follow-up. Mixed models were used to evaluate the effect of the ILI on left atrial (LA) structure and function. Results. In the subsample (n=534), mean age at inclusion was 66 years (SD 5 years), and 40% of the participants were women. Over the 5-year period, both groups experienced worsening of LA structure and function, with increases in LA volumes and stiffness index and decreases in LA longitudinal strain, LA function index and LA emptying fraction over time. Changes in the ILI and control group were not significantly different for any of the primary outcomes (LA emptying fraction: -0.95% (95%CI -0.93, -0.98) in control group, -0.97% (95%CI -0.94, -1.00) in ILI group, pbetween groups=0.80; LA longitudinal strain: 0.82% (95%CI 0.79, 0.85) in control group, 0.85% (95%CI 0.82, 0.89) in ILI group, pbetween groups=0.24) or any of the secondary outcomes. Conclusions. In overweight or obese people with MetS, an ILI had no impact on the underlying structural and functional cardiac substrate of AF, as assessed by transthoracic echocardiography.

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Automated left atrial volume measurement by two-dimensional speckle-tracking echocardiography: feasibility, accuracy, and reproducibility

Cited by 16 publications

References 27 publications

Reference ranges of tricuspid annulus geometry in healthy adults using a dedicated three-dimensional echocardiography software package

Reference ranges of tricuspid annulus geometry in healthy adults using a dedicated three-dimensional echocardiography software package

Associations of alcohol consumption with left atrial morphology and function in a population at high cardiovascular risk

Effect of an intensive lifestyle intervention on the structural and functional substrate for atrial fibrillation in people with metabolic syndrome

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