Left Ventricular Mass and Hypertrophy by Echocardiography and Cardiac Magnetic Resonance: The Multi‐Ethnic Study of Atherosclerosis

Abstract

BACKGROUND Left ventricular mass (LVM) and hypertrophy (LVH) are important parameters, but their use is surrounded by controversies. We compare LVM by echocardiography and cardiac magnetic resonance (CMR), investigating reproducibility aspects and the effect of echocardiography image quality. We also compare indexing methods within and between imaging modalities for classification of LVH and cardiovascular risk. METHODS MESA enrolled 880 participants in Baltimore City; 146 had echocardiograms and CMR on the same day. LVM was then assessed using standard techniques. Echocardiography image quality was rated (good/limited) according to the parasternal view. LVH was defined after indexing LVM to body surface area, height1.7, height2.7, or by the predicted LVM from a reference group. Participants were classified for cardiovascular risk according to Framingham score. Pearson’s correlation, Bland-Altman plots, percent agreement, and kappa coefficient assessed agreement within and between modalities. RESULTS LVM by echocardiography (140 ± 40 g) and by CMR were correlated (r = 0.8, p < 0.001) regardless of the echocardiography image quality. The reproducibility profile had strong correlations and agreement for both modalities. Image quality groups had similar characteristics; those with good images compared to CMR slightly superiorly. The prevalence of LVH tended to be higher with higher cardiovascular risk. The agreement for LVH between imaging modalities ranged from 77% to 98% and the kappa coefficient from 0.10 to 0.76. CONCLUSIONS Echocardiography has a reliable performance for LVM assessment and classification of LVH, with limited influence of image quality. Echocardiography and CMR differ in the assessment of LVH, and additional differences rise from the indexing methods.

Electrocardiographic and Echocardiographic Left Ventricular Hypertrophy in the Prediction of Stroke in the Elderly

“…The QRS changes that occur with ECG-LVH have been shown to represent a combination of anatomic and electric remodeling [24, 25]. In contrast, echo-LVH commonly relies entirely on left ventricular mass [26]. Although differences potentially exist in the cardiac pathology that is detected, equally important prognostic information regarding stroke risk is obtained from both ECG-LVH and echo-LVH.…”

“…Similarly, we defined echo-LVH by left ventricular mass values >95 th sex-specific percentiles. Other definitions for echo-LVH have been proposed and the results may vary with alternative definitions [26]. Additionally, the definition of echo-LVH used was based on left ventricular mass which depends on assumptions of left ventricular geometry and the indexing method.…”

Genetic anticipation in a special form of hypertrophic cardiomyopathy with sudden cardiac death in a family with 74 members across 5 generations

“…A recent study indicated that combined CMR high-resolution quantitative assessment of myocardial perfusion and LV fibrosis is feasible in patients with HCM, in addition to late gadolinium enhancement. [43] This method could provide more accurate information on the ischemic burden, which may have potential significance in the outcome of HCM. [44] Other parameters that are considered important markers for cardiovascular prognosis and therapeutic responses, such as LV mass or LV hypertrophy, should also be measured by CMR in HCM.…”

“…[44] Other parameters that are considered important markers for cardiovascular prognosis and therapeutic responses, such as LV mass or LV hypertrophy, should also be measured by CMR in HCM. [43,45] …”

Association of Cardiac Structural and Functional Abnormalities With Gestational Diabetes

“…In fact, echocardiography-derived LV mass and hypertrophy are validated, widely available, and accurate measurements. (13,14) Moreover, LV mass is a powerful predictor of major cardiovascular outcomes; even in early adulthood, when CV risk factors exposition is still incipient. (15,16) Therefore, LV mass index raises as an early marker of cardiac remodeling in patients with gestational diabetes.…”