Simplified Single Plane Echocardiography Is Comparable to Conventional Biplane Two‐Dimensional Echocardiography in the Evaluation of Left Atrial Volume: A Study Validated by Three‐Dimensional Echocardiography in 143 Individuals

Abstract

The left atrial volume index (LAVI) is a biomarker of diastolic dysfunction and a predictor of cardiovascular events. Three-dimensional echocardiography (3DE) is highly accurate for LAVI measurements but is not widely available. Furthermore, biplane two-dimensional echocardiography (B2DE) may occasionally not be feasible due to a suboptimal two-chamber apical view. Simplified single plane two-dimensional echocardiography (S2DE) could overcome these limitations. We aimed to compare the reliability of S2DE with other validated echocardiographic methods in the measurement of the LAVI. We examined 143 individuals (54 ± 13 years old; 112 with heart disease and 31 healthy volunteers; all with sinus rhythm, with a wide range of LAVI). The results for all the individuals were compared with B2DE-derived LAVIs and validated using 3DE. The LAVIs, as determined using S2DE (32.7 ± 13.1 mL/m(2)), B2DE (31.9 ± 12.7 mL/m(2)), and 3DE (33.1 ± 13.4 mL/m(2)), were not significantly different from each other (P = 0.85). The S2DE-derived LAVIs correlated significantly with those obtained using both B2DE (r = 0.98; P < 0.001) and 3DE (r = 0.93; P < 0.001). The mean difference between the S2DE and B2DE measurements was <1.0 mL/m(2). Using the American Society of Echocardiography criteria for grading LAVI enlargement (normal, mild, moderate, severe), we observed an excellent agreement between the S2DE- and B2DE-derived classifications (κ = 0.89; P < 0.001). S2DE is a simple, rapid, and reliable method for LAVI measurement that may expand the use of this important biomarker in routine echocardiographic practice.

Real‐time three‐dimensional echocardiography for left atrial volume assessment in Thoroughbred racehorses: Observer variability and comparison with two‐dimensional echocardiography

“…There is evidence in human medicine that single plane echocardiography is comparable to biplane 2DE in the evaluation of LAV. 27 Repeat measurement of 2DE images showed more variation in LAV min values than 3DE in the horses in this study. In human cardiology, 3DE LAV measurements performed better in terms of correlation, bias, limits of agreement and interobserver variability 14,15 and had superior prognostic ability.…”

Comparative assessment of left atrial volume in healthy cats by two-dimensional and three-dimensional echocardiography

“…Since biplane SMOD did not show significant difference to LAMax results of monoplane r4 and l2, measuring two planes does not provide additional benefit in healthy cats. In human medicine, no significant difference between monoplane and biplane SMOD was found in healthy patients as well as patients with cardiac diseases [ 36 ]. Nevertheless, the American Association of Echocardiography and the European Association of Cardiovascular Imaging recommend biplane SMOD as standard technique for LA volumetry, because monoplane SMOD formula assumes circular LA shape in the short axis view, which is not always accurate [ 12 ].…”

Utility of serial 12-lead electrocardiograms in children with Marfan syndrome

“…and E.S.S.T. 10 . Left atrial dilation was defined as a left atrial volume ⩾29 ml/m 2 or z-score ⩾2 11 …”

“…8,9 Left atrial volume was measured by single plane in the apical view and indexed to body surface area by two independent blinded investigators -C.T. N. and E.S.S.T.. 10 Left atrial dilation was defined as a left atrial volume ⩾29 ml/m 2 or z-score ⩾2. 11,12 Two investigators, C.T.N.…”