Motoc Andreea, Roosens Bram, Scheirlynck Esther, Tanaka Kaoru, Luchian Maria Luiza, Magne Julien, Mandoli Giulia Elena, Hinojar Rocio, Cameli Matteo, Zamorano Jose Luis, Droogmans Steven, Cosyns Bernard
Centrum Voor Hart-en Vaatziekten (CHVZ), Department of Cardiology, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
Radiology Department, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
Diagnostics (Basel). 2020 Dec 3;10(12):1043. doi: 10.3390/diagnostics10121043.
Left atrium (LA) volume is a biomarker of cardiovascular outcomes. Three-dimensional echocardiography (3DE) provides an accurate LA evaluation, but data regarding the optimal 3DE method is scarce. We assessed the feasibility and reproducibility of LA measurements using different 3DE methods. One hundred and ninety-four patients were prospectively analyzed. Conventional 3DE and two semi-automatic 3DE algorithms (Tomtec™ and Dynamic Heart Model (DHM)) were used in 110 patients. Intra- and interobserver reproducibility and intervendor comparison were performed in additional patients' subsets. Forty patients underwent cardiac magnetic resonance (CMR). Feasibility was 100% for Tomtec, 98.2% for DHM, and 72.8% for conventional 3DE. Tomtec volumes were higher than 3DE and DHM ( < 0.001). Reproducibility was better for DHM (intraobserver LA maximum volume (LAmax) ICC 0.99 (95% CI 1.0-0.99), LA minimum volume (LAmin) 0.98 (95% CI 0.95-0.99), LApreA 0.96 (95% CI 0.91-0.98); interobserver LAmax ICC 0.98 (95% CI 0.96-0.99), LAmin 0.99 (95% CI 0.99-1.00), and LApreA 0.97 (95% CI 0.94-0.99)). Intervendor comparison showed differences between left ventricle (LV) software adapted for LA ( < 0.001). Tomtec underestimated the least LA volumes compared to CMR. These findings emphasize that dedicated software should be used for LA assessment, for consistent clinical longitudinal follow-up and research.
左心房（LA）容积是心血管疾病预后的生物标志物。三维超声心动图（3DE）可对左心房进行准确评估，但关于最佳3DE方法的数据却很匮乏。我们评估了使用不同3DE方法测量左心房的可行性和可重复性。对194例患者进行了前瞻性分析。110例患者使用了传统3DE和两种半自动3DE算法（Tomtec™和动态心脏模型（DHM））。在另外的患者亚组中进行了观察者内和观察者间的可重复性以及不同供应商之间的比较。40例患者接受了心脏磁共振成像（CMR）检查。Tomtec的可行性为100%，DHM为98.2%，传统3DE为72.8%。Tomtec测量的容积高于3DE和DHM（<0.001）。DHM的可重复性更好（观察者内左心房最大容积（LAmax）组内相关系数（ICC）为0.99（95%可信区间1.0 - 0.99），左心房最小容积（LAmin）为0.98（95%可信区间0.95 - 0.99），左心房预面积（LApreA）为0.96（95%可信区间0.91 - 0.98）；观察者间LAmax的ICC为0.98（95%可信区间0.96 - 0.99），LAmin为0.99（95%可信区间0.99 - 1.00），LApreA为0.97（95%可信区间0.94 - 0.99））。不同供应商之间的比较显示，适用于左心房的左心室（LV）软件存在差异（<0.001）。与CMR相比，Tomtec对左心房容积的低估最少。这些发现强调，为了进行一致的临床纵向随访和研究，应使用专用软件进行左心房评估。
