Canciello Grazia, de Simone Giovanni, Izzo Raffaele, Giamundo Alessandra, Pacelli Filomena, Mancusi Costantino, Galderisi Maurizio, Trimarco Bruno, Losi Maria-Angela
Hypertension Research Center, Federico II University Hospital, Naples, Italy.
Hypertension Research Center, Federico II University Hospital, Naples, Italy.
J Am Soc Echocardiogr. 2017 Mar;30(3):262-269. doi: 10.1016/j.echo.2016.11.017. Epub 2016 Dec 31.
Measurement of left atrial (LA) volume (LAV) is recommended for quantification of LA size. Only LA anteroposterior diameter (LAd) is available in a number of large cohorts, trials, or registries. The aim of this study was to evaluate whether LAV may be reasonably estimated from LAd.
One hundred forty consecutive patients referred to our outpatient clinics were prospectively enrolled to measure LAd from the long-axis view on two-dimensional echocardiography. LA orthogonal dimensions were also taken from apical four- and two-chamber views. LAV was measured using the Simpson, area-length, and ellipsoid (LAV) methods. The first 70 patients were the learning series and the last 70 the testing series (TeS). In the learning series, best-fitting regression analysis of LAV-LAd was run using all LAV methods, and the highest values of F were chosen among the regression equations. In the TeS, the best-fitting regressions were used to estimate LAV from LAd.
In the learning series, the best-fitting regression was linear for the Spearman method (r = 0.62, F = 111.85, P = .0001) and area-length method (r = 0.62, F = 112.24, P = .0001) and powered for the LAV method (r = 0.81, F = 288.41, P = .0001). In the TeS, the r value for LAV prediction was substantially better using the LAV method (r = 0.89) than the Simpson (r = 0.72) or area-length (r = 0.70) method, as was the intraclass correlation (ρ = 0.96 vs ρ = 0.89 and ρ = 0.89, respectively). In the TeS, the sensitivity and specificity of LA dilatation by the estimated LAV method were 87% and 90%, respectively.
LAV can be estimated from LAd using a nonlinear equation with an elliptical model. The proposed method may be used in retrospective analysis of existing data sets in which determination of LAV was not programmed.
推荐测量左心房（LA）容积（LAV）以量化LA大小。在许多大型队列研究、试验或登记处中，仅有LA前后径（LAd）的数据可用。本研究的目的是评估是否可以根据LAd合理估计LAV。
前瞻性纳入连续140例到我们门诊就诊的患者，通过二维超声心动图从长轴视图测量LAd。还从心尖四腔和两腔视图获取LA的正交维度。使用Simpson法、面积-长度法和椭圆体（LAV）法测量LAV。前70例患者为学习系列，后70例为测试系列（TeS）。在学习系列中，使用所有LAV测量方法对LAV-LAd进行最佳拟合回归分析，并在回归方程中选择F值最高的方程。在TeS中，使用最佳拟合回归方程根据LAd估计LAV。
在学习系列中，Spearman法（r = 0.62，F = 111.85，P = .0001）和面积-长度法（r = 0.62，F = 112.24，P = .0001）的最佳拟合回归为线性，LAV法（r = 0.81，F = 288.41，P = .0001）的最佳拟合回归为幂函数形式。在TeS中，使用LAV法预测LAV的r值（r = 0.89）明显优于Simpson法（r = 0.72）或面积-长度法（r = 0.70），组内相关系数也是如此（分别为ρ = 0.96 vs ρ = 0.89和ρ = 0.89）。在TeS中，通过估计的LAV法诊断LA扩张的敏感性和特异性分别为87%和90%。
可使用椭圆模型的非线性方程根据LAd估计LAV。所提出的方法可用于对未设置LAV测定程序的现有数据集进行回顾性分析。
