Comparison of Accuracy of Left Atrial Area and Volume by Two-dimensional Trans-thoracic Echocardiography Versus Computed Tomography

Arsanjani, Reza; Flint, Nir; Beigel, Roy; Khachatryan, Tigran; Shaleṿ, Aryeh; Shturman, Alexander; Lee, Chin; Rader, Florian; Berman, Daniel S.; Heo, Ran; Siegel, Robert J.

doi:10.1016/j.amjcard.2018.12.047

Cited by 15 publications

(11 citation statements)

References 16 publications

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“…Correct diagnosis of group 2 PH can be challenging, especially in cases of heart failure with preserved ejection fraction, and the diagnostic pathway should be based on the pre-test probability of LHD [ 3 ]. As CTPA is frequently acquired in addition to echocardiography during diagnostic workup [ 3 , 25 , 26 ], including CTPA-based parameters into the estimation of pre-test probability of LHD appears to be a promising approach for translation into clinical practice and may improve confidence when deciding which patient may require invasive catheterisation. LA area and volume can also be estimated by transthoracic echocardiography using planar measurements and geometric assumptions [ 3 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic accuracy of automated 3D volumetry of cardiac chambers by CT pulmonary angiography for identification of pulmonary hypertension due to left heart disease

et al. 2022

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Objectives To assess diagnostic accuracy of automated 3D volumetry of cardiac chambers based on computed tomography pulmonary angiography (CTPA) for the differentiation of pulmonary hypertension due to left heart disease (group 2 PH) from non-group 2 PH compared to manual diameter measurements. Methods Patients with confirmed PH undergoing right heart catheterisation and CTPA within 100 days for diagnostic workup of PH between August 2013 and February 2016 were included in this retrospective, single-centre study. Automated 3D segmentation of left atrium, left ventricle, right atrium and right ventricle (LA/LV/RA/RV) was performed by two independent and blinded radiologists using commercial software. For comparison, axial diameters were manually measured. The ability to differentiate group 2 PH from non-group 2 PH was assessed by means of logistic regression. Results Ninety-one patients (median 67.5 years, 44 women) were included, thereof 19 patients (20.9%) classified as group 2 PH. After adjustment for age, sex and mean pulmonary arterial pressure, group 2 PH was significantly associated with larger LA volume (p < 0.001), larger LV volume (p = 0.001), lower RV/LV volume ratio (p = 0.04) and lower RV/LA volume ratio (p = 0.003). LA volume demonstrated the highest discriminatory ability to identify group 2 PH (AUC, 0.908; 95% confidence interval, 0.835–0.981) and was significantly superior to LA diameter (p = 0.009). Intraobserver and interobserver agreements were excellent for all volume measurements (intraclass correlation coefficients 0.926–0.999, all p < 0.001). Conclusions LA volume quantified by automated, CTPA-based 3D volumetry can differentiate group 2 PH from other PH groups with good diagnostic accuracy and yields significantly higher diagnostic accuracy than left atrial diameter. Key Points • Automated cardiac chamber volumetry using non-gated CT pulmonary angiography can differentiate pulmonary hypertension due to left heart disease from other causes with good diagnostic accuracy. • Left atrial volume yields significantly higher diagnostic accuracy than left atrial axial diameter for identification of pulmonary hypertension due to left heart disease without time-consuming manual processing.

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Section: Discussionmentioning

confidence: 99%

“…LA area and volume can also be estimated by transthoracic echocardiography using planar measurements and geometric assumptions [ 3 , 25 ]. However, LA volume estimation by echocardiography has been shown to be less accurate compared to CT-based volume measurements [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of automated 3D volumetry of cardiac chambers by CT pulmonary angiography for identification of pulmonary hypertension due to left heart disease

et al. 2022

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“…Recentemente, o volume atrial esquerdo tem sido usado como medida do aumento atrial esquerdo. 19 Esse índice pode ser incluído em estudos futuros. Neste estudo, os pacientes foram estratificados de acordo com o escore CHA2DS2-VASc, a fim de analisar o efeito do DAE na trombose atrial esquerda/trombose de apêndice atrial esquerdo.…”

Section: Discussionunclassified

Valor do Diâmetro do Átrio Esquerdo com Escore CHA2DS2-Vasc na Predição da Trombose Atrial Esquerda/Trombose de Apêndice Atrial Esquerdo na Fibrilação Atrial Não Valvar

Zhang

Yang

2021

Arquivos Brasileiros De Cardiologia

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Fundamentos: A fibrilação atrial é a arritmia persistente mais comum e é o principal fator que leva ao tromboembolismo. Objetivo: Investigar o valor do diâmetro do átrio esquerdo combinado com o escore CHA2DS2-VASc na predição da trombose atrial esquerda/trombose de apêndice atrial esquerdo na fibrilação atrial não valvar. Métodos: Trata-se de estudo retrospectivo. 238 pacientes com fibrilação atrial não valvar foram selecionados e divididos em dois grupos: trombose e não trombose. Determinou-se o escore CHA2DS2-VASc. Valores de p<0,05 foram considerados estatisticamente significativos. Resultados: A análise de regressão logística multivariada revelou que histórico de acidente vascular cerebral/ataque isquêmico transitório, doença vascular, escore CHA2DS2-VASc, DAE, DDFVE e FEVE foram fatores de risco independentes para trombose atrial esquerda/trombose de apêndice atrial esquerdo (p<0,05). A análise da curva ROC (Receiver Operating Characteristic) revelou que a área sob a curva para o escore CHA2DS2-VASc na predição de trombose atrial esquerda/trombose de apêndice atrial esquerdo foi de 0,593 quando o escore CHA2DS2-VASc foi ≥3 pontos, e a sensibilidade e especificidade foram 86,5% e 32,6%, respectivamente, enquanto a área sob a curva para o DAE na predição de trombose atrial esquerda/trombose de apêndice atrial esquerdo foi 0,786 quando o DAE foi ≥44,17 mm, e a sensibilidade e especificidade foram 89,6% e 60,9%, respectivamente. Entre os diferentes grupos CHA2DS2-VASc, a taxa de incidência de trombose atrial esquerda/trombose de apêndice atrial esquerdo em pacientes com DAE ≥44,17 mm foi maior do que em pacientes com DAE <44,17 mm (p <0,05). Conclusão: O escore CHA2DS2-VASc e o DAE estão correlacionados com a trombose atrial esquerda/trombose de apêndice atrial esquerdo na fibrilação atrial não valvar. Para pacientes com escore CHA2DS2-VASc de 0 ou 1, quando o DAE é ≥44,17 mm, o risco de trombose atrial esquerda/trombose de apêndice atrial esquerdo permaneceu alto.

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“…e shortest longitudinal atrial diameters (L) and end-systolic atrial area were measured on two-(A1) and four-chamber (A2) views of the CTA images using the Carestream version 11 software (Phillips, Amsterdam, e Netherlands). LA volume and RA volume (LAV/RAV ml) were calculated according to the following area-length method based on the literature ( [14][15][16]. Afterwards, the indexed LAV and RAV (LAVI/RAVI, ml/m 2 ) were calculated based on the body surface area (BSA) of each patient.…”

Section: Measurement Of Atrial Diameters and Volumesmentioning

confidence: 99%

The Value of Voltage Histogram Analysis Derived Right Atrial Scar Burden in the Prediction of Left Atrial Scar Burden

Herczeg

Galvin

Keaney

et al. 2020

Cardiology Research and Practice

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Introduction. Growing evidence suggests that fibrotic changes can be observed in atrial fibrillation (AF) in both atria. Quantification of the scar burden during electroanatomical mapping might have important therapeutic and prognostic consequences. However, as the current invasive treatment of AF is focused on the left atrium (LA), the role of the right atrium (RA) is less well understood. We aimed to characterize the clinical determinates of the RA low-voltage burden and its relation to the LA scaring. Methods. We have included 36 patients who underwent catheter ablation for AF in a prospective observational study. In addition to LA mapping and ablation, high-density RA bipolar voltage maps (HD-EAM) were also reconstructed. The extent of the diseased RA tissue (≤0.5 mV) was quantified using the voltage histogram analysis tool (CARTO®3, Biosense Webster). Results. The percentage of RA diseased tissue burden was significantly higher in patients with a CHA2DS2-VASc score ≥ 2 p=0.0305, higher indexed LA volume on the CTA scan and on the HD‐EAM (p=0.0223 and p=0.0064, respectively), or higher indexed RA volume on the HD‐EAM p=0.0026. High RA diseased tissue burden predicted the presence of high LA diseased tissue burden (OR = 7.1, CI (95%): 1.3–38.9, p=0.0145), and there was a significant correlation of the same (r = 0.6461, p<0.0001). Conclusions. Determining the extent of the right atrial low-voltage burden might give useful clinical information. According to our results, the diseased tissue burden correlates well between the two atria: the right atrium mirrors the left atrium.

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Comparison of Accuracy of Left Atrial Area and Volume by Two-dimensional Trans-thoracic Echocardiography Versus Computed Tomography

Cited by 15 publications

References 16 publications

Diagnostic accuracy of automated 3D volumetry of cardiac chambers by CT pulmonary angiography for identification of pulmonary hypertension due to left heart disease

Diagnostic accuracy of automated 3D volumetry of cardiac chambers by CT pulmonary angiography for identification of pulmonary hypertension due to left heart disease

Valor do Diâmetro do Átrio Esquerdo com Escore CHA2DS2-Vasc na Predição da Trombose Atrial Esquerda/Trombose de Apêndice Atrial Esquerdo na Fibrilação Atrial Não Valvar

The Value of Voltage Histogram Analysis Derived Right Atrial Scar Burden in the Prediction of Left Atrial Scar Burden

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