Automated quantification of left atrial size using three-beat averaging real-time three dimensional Echocardiography in patients with atrial fibrillation

作者：Heo Ran; Hong Geu Ru^*; Kim Young Jin; Mancina Joel; Cho In Jeong; Shim Chi Young; Chang Hyuk Jae; Ha Jong Won; Chung Namsik

来源：Cardiovascular Ultrasound, 2015, 13(1): 38.

DOI：10.1186/s12947-015-0032-5

• Three-dimensional echocardiography
• Left atrial volume
• Atrial fibrillation

Background: Left atrial (LA) sizing in patients with atrial fibrillation (AF) is crucial for follow-up and outcome. Recently, the automated quantification of LA using the novel three-beat averaging real-time three dimensional echocardiography (3BA-RT3DE) is introduced. The aim of this study was to assess the feasibility and accuracy of 3BA-RT3DE in patients with atrial fibrillation (AF).
Methods: Thirty-one patients with AF (62.8 +/- 11.7 years, 67.7 % male) were prospectively recruited to have two dimensional echocardiography (2DE) and 3BA-RT3DE (SC 2000, ACUSON, USA). The maximal left atrial (LA) volume was measured by the conventional prolate-ellipse (PE) and area-length (AL) method using three-beat averaging 2D transthoracic echocardiography and automated software analysis (eSie volume analysis, Siemens Medical Solution, Mountain view, USA); measurements were compared with those obtained by computed tomography (CT).
Results: Maximal LA volume by 3BA-RT3DE was feasible for all patients. LA volume was 68.4 +/- 28.2 by PE-2DE, 89.2 +/- 33.1 by AL-2DE, 100.6 +/- 31.8 by 3BA-RT3DE, and 131.2 +/- 42.2 mL by CT. LA volume from PE-2DE (R-2 = 0.48, p < 0.001, ICC = 0.64, p < 0.001), AL-2DE (R-2 = 0.47, p < 0.001, ICC = 0.67, p < 0.001), and 3BA-RT3DE (R-2 = 0.50, p = 0.001, ICC = 0.65, p < 0.001) showed significant correlations with CT. However, 3BA-RT3DE demonstrated a small degree of underestimation (30.5 mL) of LA volume compared to 2DE-based measurements. Good-quality images from 3BA-RT3DE (n = 16) showed a significantly tighter correlation with images from CT scanning (R-2 = 0.60, p = 0.0004, ICC = 0.76, p < 0.001) compared to those of fair quality.
Conclusion: Automated quantification of LA volume using 3BA-RT3DE is feasible and accurate in patients with AF. An image of good quality is essential for maximizing the value of this method in clinical practice.

• 出版日期2015-8-25