TY - JOUR

T1 - Accuracy, analysis time, and reproducibility of dedicated 4D echocardiographic left atrial volume quantification software

AU - Olsen, Flemming Javier

AU - Bertelsen, Litten

AU - Vejlstrup, Niels

AU - Bjerregaard, Caroline Løkke

AU - Diederichsen, Søren Zöga

AU - Jørgensen, Peter Godsk

AU - Jensen, Magnus T.

AU - Dahl, Anders

AU - Landler, Nino Emmanuel

AU - Graff, Claus

AU - Brandes, Axel

AU - Krieger, Derk

AU - Haugan, Ketil

AU - Køber, Lars

AU - Højberg, Søren

AU - Svendsen, Jesper Hastrup

AU - Biering-Sørensen, Tor

N1 - Funding Information: The LOOP study was supported by unrestricted research grants from the Innovation Fund Denmark, the Research Foundation for the Capital Region of Denmark, the Danish Heart Foundation, Aalborg University Talent Management Programme, and the Arvid Nilsson Foundation and Medtronic. FJO was funded by Copenhagen University Hospital - Herlev and Gentofte, Kong Christian den Tiendes Fond, Fru Asta Florida Boldings Mindelegat, and the Danish Heart Foundation (Grant No.: 18-R125-A8534-22083). TBS was funded by Herlev and Gentofte Hospital, Fondsbørsvekselerer Henry Hansen og Hustrus Hovedlegat, the Lundbeck Foundation and the Novo Nordisk foundation. Funding Information: PGJ: Speaker Honorarium: Novo Nordisk and Astra Zeneca. TBS: Steering Committee member: the Amgen financed GALACTIC-HF trial and the Boston Scientific financed LUX-Dx TRENDS trial; Advisory Board: Sanofi Pasteur and Amgen; Speaker Honorarium: Novartis and Sanofi Pasteur; Research grant: GE Healthcare and Sanofi Pasteur. JHS: Advisory board: Medtronic. Research grant and speaker fee from Medtronic in relation to this study. LK: Speakers honorarium from Novo, Novartis, AstraZeneca and Boehringer. SZD: Advisory for Vital Beats. KH: travel and educational grants from Medtronic, Abbott, and BIOTRONIK and speaker honoraria from Boehringer-Ingelheim not related to this work. AB: Research grants from the Region of Southern Denmark, the Region of Zealand, and Theravance. Speaker honorarium from Bayer, Boehringer Ingelheim, and Bristol-Myers Squibb. Travel grant from Biotronik. The other authors have no potential conflict of interest to report. Publisher Copyright: © 2022, The Author(s), under exclusive licence to Springer Nature B.V.

PY - 2022

Y1 - 2022

N2 - Four-dimensional (4D) echocardiography may provide more accurate estimations of left atrial (LA) volumes than 2-dimensional (2D) measures. We sought to compare the concordance of a novel 4D LA quantification software versus 2D echocardiography against cardiac magnetic resonance (CMR). This was a multimodality imaging substudy of a randomized clinical trial (the LOOP study). Elderly participants with stroke risk factors were included. A subgroup of this study population underwent transthoracic echocardiography (n = 1441) and a subset underwent CMR within two weeks (n = 73). The mean age of the echocardiographic study population was 74 years and 54% were men. The maximal LA volume (LAVmax) was 47 mL by 2D, 52 mL by 4D, and 104 mL by CMR. While 2D echocardiography showed a moderate correlation with 4D (R2 = 0.51) it yielded significantly lower values for LAVmax with a mean difference of 4.5 ± 11.9 mL, p < 0.001. 4D echocardiography correlated strongly with CMR measurements (R2 = 0.70), whereas 2D echocardiography showed a moderate correlation (R2 = 0.53). However, both modalities systematically underestimated LAVmax largely compared to CMR (2D vs. CMR: − 54.9 ± 21.3 mL; 4D vs. CMR: − 49.7 ± 18.6 mL). Similar observations were made for minimal LA volume and LA volume before atrial contraction. Analyses time by 4D was shorter than for 2D (90 ± 11 vs. 118 ± 16 s, p < 0.001). Intra- and interobserver variability was lower for 4D than 2D. Four-dimensional echocardiography is faster, more reproducible, and correlates more closely to CMR than 2D echocardiography. Both 4D and 2D echocardiography systematically underestimates LA volumes compared to CMR, emphasizing that values of LA volumes are not interchangeable between echocardiography and CMR.

AB - Four-dimensional (4D) echocardiography may provide more accurate estimations of left atrial (LA) volumes than 2-dimensional (2D) measures. We sought to compare the concordance of a novel 4D LA quantification software versus 2D echocardiography against cardiac magnetic resonance (CMR). This was a multimodality imaging substudy of a randomized clinical trial (the LOOP study). Elderly participants with stroke risk factors were included. A subgroup of this study population underwent transthoracic echocardiography (n = 1441) and a subset underwent CMR within two weeks (n = 73). The mean age of the echocardiographic study population was 74 years and 54% were men. The maximal LA volume (LAVmax) was 47 mL by 2D, 52 mL by 4D, and 104 mL by CMR. While 2D echocardiography showed a moderate correlation with 4D (R2 = 0.51) it yielded significantly lower values for LAVmax with a mean difference of 4.5 ± 11.9 mL, p < 0.001. 4D echocardiography correlated strongly with CMR measurements (R2 = 0.70), whereas 2D echocardiography showed a moderate correlation (R2 = 0.53). However, both modalities systematically underestimated LAVmax largely compared to CMR (2D vs. CMR: − 54.9 ± 21.3 mL; 4D vs. CMR: − 49.7 ± 18.6 mL). Similar observations were made for minimal LA volume and LA volume before atrial contraction. Analyses time by 4D was shorter than for 2D (90 ± 11 vs. 118 ± 16 s, p < 0.001). Intra- and interobserver variability was lower for 4D than 2D. Four-dimensional echocardiography is faster, more reproducible, and correlates more closely to CMR than 2D echocardiography. Both 4D and 2D echocardiography systematically underestimates LA volumes compared to CMR, emphasizing that values of LA volumes are not interchangeable between echocardiography and CMR.

KW - 4D

KW - CMR

KW - Echocardiography

KW - Left atrium

U2 - 10.1007/s10554-021-02512-9

DO - 10.1007/s10554-021-02512-9

M3 - Journal article

C2 - 34981209

AN - SCOPUS:85122232828

VL - 38

SP - 1277

EP - 1288

JO - International Journal of Cardiovascular Imaging

JF - International Journal of Cardiovascular Imaging

SN - 1569-5794

ER -