The Accuracy of Echocardiographic Assessment of Left Ventricular Size in Children by the 5/6 Area × Length (Bullet) Method

Nielsen, James C.; Lytrivi, Irene D.; Ko, H. Helen; Yau, Jen; Bhatla, Puneet; Parness, Ira A.; Srivastava, Shubhika

doi:10.1111/j.1540-8175.2009.01120.x

Cited by 17 publications

(11 citation statements)

References 17 publications

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“…Normative values in children based on the 5/6AL method as used in this study have been published(11), and Lytrivi and colleagues recently published normal values for the 5/6AL method, utilizing subcostal imaging planes rather than parasternal/apical planes, as this study used (12). Nielsen described good correlations between the 5/6AL method with CMR in a small series of children under 10 years of age (13). Utilizing parasternal/apical planes in larger patients may be superior to subcostal planes, however, due to decreased subcostal window availability.…”

Section: Discussionmentioning

confidence: 98%

The Reproducibility and Absolute Values of Echocardiographic Measurements of Left Ventricular Size and Function in Children Are Algorithm Dependent

Margossian

Chen

Sleeper

et al. 2015

Journal of the American Society of Echocardiography

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Background Several quantification algorithms for measuring left ventricular (LV) size and function are used in clinical and research settings. We investigated the effect of the measurement algorithm and beat averaging on the reproducibility of measurements of the LV and assessed the magnitude of agreement among the algorithms in children with dilated cardiomyopathy (DCM). Methods Echocardiograms were obtained on 169 children from 8 clinical centers. Inter- and intra-reader reproducibility were assessed on measurements of LV volumes using biplane Simpson, modified Simpson (MS), and 5/6 x area x length (5/6AL) algorithms. Percent error (%error) was calculated as the inter- or intra-reader difference / mean x 100. Single beat measurements and the 3-beat average (3BA) were compared. Intra-class correlation coefficients (ICC) were calculated to assess agreement. Results Single beat inter-reader reproducibility was lowest (%error was highest) using biplane Simpson; 5/6AL and MS were similar but significantly better than biplane Simpson (p<.05). Single beat intra-reader reproducibility was highest using 5/6AL (p<.05). 3BA improved reproducibility for almost all measures (p<.05). Reproducibility in both single and 3BA values fell with greater LV dilation and systolic dysfunction (p<.05). ICCs were > 0.95 across measures, although absolute volume and mass values were systematically lower for biplane Simpson compared to MS and to 5/6AL. Conclusions The reproducibility of LV size and function measurements in children with DCM is highest using the 5/6AL algorithm, and can be further improved by using 3BA. However, values derived from different algorithms are not interchangeable.

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Section: Discussionmentioning

confidence: 98%

The Reproducibility and Absolute Values of Echocardiographic Measurements of Left Ventricular Size and Function in Children Are Algorithm Dependent

Margossian

Chen

Sleeper

et al. 2015

Journal of the American Society of Echocardiography

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“…[7][8][9][10] Pediatric nomograms for cardiac chamber diameters and areas, however, are still limited or even absent. 2,[11][12][13][14] For the left ventricle, there are sufficient nomograms for M-mode measurements, [7][8][9][10] while normal values for left ventricular diameters and areas evaluated in two-and four-chamber views are almost absent. Furthermore, pediatric echocardiographic nomograms for right ventricular dimensions 12 and atrial dimensions 15 are also extremely limited.…”

mentioning

confidence: 99%

Echocardiographic Nomograms for Chamber Diameters and Areas in Caucasian Children

Cantinotti

Scalese

Murzi

et al. 2014

Journal of the American Society of Echocardiography

126

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“…FS was calculated as: [(LVEDD-LVESD) / LVEDD] × 100. EF was calculated by the 5/6 area-length method as: 5/6 × [(LVAD × LVLD) − (LVAS × LVLS)] / (LVAD × LVLD) × 100 (6, 7). Categories of LV function based on FS and EF were assigned according to guidelines from the American Society of Echocardiography as normal (FS ≥ 28 and EF ≥ 55), mildly depressed (FS 22–27 and EF 45–54), moderately depressed (FS 17–21 and EF 30–44), or severely depressed (FS ≤ 16 and EF < 30) (8).…”

Section: Methodsmentioning

confidence: 99%

Reliability of echocardiographic measurements of left ventricular systolic function in potential pediatric heart transplant donors

Chen¹,

Tierney²,

Khush³

et al. 2015

The Journal of Heart and Lung Transplantation

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Background Echocardiogram reports, but not images, are usually available for the evaluation of potential donor hearts. To assess the reliability of local reports of potential pediatric heart donors, we compared echocardiographic measurements of left ventricular (LV) systolic function between local hospitals and a central echocardiography laboratory. Methods We identified all potential donors <18 years old managed by the California Transplant Donor Network from 2009–2013. Echocardiograms and reports were obtained from local hospitals. All studies were reviewed in a central laboratory by an experienced pediatric cardiologist blinded to local reports. Local and central measurements of fractional shortening (FS) were compared using the method of Bland and Altman (mean difference±2SD). LV function was categorized based on FS as normal or mild, moderately, or severely depressed. Results There were 70 studies from 59 donors with both local and central measurements of FS. The mean difference between local and central FS was 3.9 (SD 9.0). The limits of agreement ranged from −14.2 to 22. Twenty-five studies had discordant measurements of LV function, with 17 discordant by one category and eight by two or more categories. Of 55 studies categorized as normal by local measurement, six were moderately to severely depressed by central review. Of 15 studies categorized as depressed by local measurement, three were normal by central review. Conclusion Local and central measurements of LV systolic function were discordant in 36% of studies. Given such discordance, efforts to obtain and view actual echocardiographic images should be part of the standard evaluation of potential pediatric heart donors.

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The Accuracy of Echocardiographic Assessment of Left Ventricular Size in Children by the 5/6 Area × Length (Bullet) Method

Abstract: Subxiphoid echocardiographic bullet method of measuring LVEDV shows a good agreement with CMR obtained LV size in young children.

Cited by 17 publications

References 17 publications

The Reproducibility and Absolute Values of Echocardiographic Measurements of Left Ventricular Size and Function in Children Are Algorithm Dependent

The Reproducibility and Absolute Values of Echocardiographic Measurements of Left Ventricular Size and Function in Children Are Algorithm Dependent

Echocardiographic Nomograms for Chamber Diameters and Areas in Caucasian Children

Reliability of echocardiographic measurements of left ventricular systolic function in potential pediatric heart transplant donors

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