Heart and Vascular Center, MetroHealth Campus of Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.
School of Medicine, University of Pittsburgh, 490 E North Avenue, Suite G104, Pittsburgh, PA, 15212, USA.
Int J Cardiovasc Imaging. 2022 Oct;38(10):2129-2137. doi: 10.1007/s10554-022-02627-7. Epub 2022 May 23.
Abnormal Left ventricular mass (LVM) prognosticates adverse cardiovascular events. Conventionally, LVM measured by echo assumes a prolate ellipsoid (PE) shape; however, it poorly correlates with reference standard of cardiac magnetic resonance imaging (CMR) derived LVM. PE model assumes LVL = 2 × LVID. We developed a new echo LVM formula based on LV length and tested for accuracy against CMR. A retrospective study of consecutive patients with an echocardiogram and CMR within 3 months. Derivation (n = 170) and validation cohorts (n = 54) were used to test the new formula. Following analysis of correlation of interventricular septum (IVS), LV internal dimension (LVID), posterior wall (PW) and LVL between echo and CMR, a novel paraboloid-shape linear regression (PLR) model was derived. LVM by both models were compared to CMR. Poor correlation observed between actual and assumed LVL (0.52 with CMR; 0.44 with echo). Strong correlation was noted between echo and CMR measured LVL, LVID, IVS (r > 0.80) and a moderate correlation with PW (r = 0.62). Strong correlation of LVL was harnessed to develop PLR model, which significantly decreased paired error in derivation cohort (from 64 ± 42 to 22 ± 21 gm) and validation cohort (from 63 ± 46 to 25 ± 18 gm). Furthermore, it demonstrates significant reduction in absolute, relative errors and variability along with superior correlation in both cohorts. Between echo and CMR, LVL demonstrates one of the best correlation among LV dimensions. The assumption, LVL = 2 × LVID appears inaccurate. PLR model incorporates LVL and significantly improves accuracy, reduces variability of LVM.
左心室质量（LVM）异常预示着不良心血管事件。传统上，通过超声测量的 LVM 假设为长椭球体（PE）形状；然而，它与心脏磁共振成像（CMR）得出的 LVM 的参考标准相关性较差。PE 模型假设 LVL=2×LVID。我们开发了一种新的基于 LV 长度的超声 LVM 公式，并对其与 CMR 的准确性进行了测试。对在 3 个月内进行超声心动图和 CMR 的连续患者进行了回顾性研究。推导（n=170）和验证队列（n=54）用于测试新公式。在分析了超声心动图和 CMR 之间的室间隔（IVS）、LV 内部直径（LVID）、后壁（PW）和 LVL 之间的相关性后，得出了一个新的抛物面线性回归（PLR）模型。将两种模型的 LVM 与 CMR 进行比较。实际 LVL 与假设 LVL 之间的相关性较差（与 CMR 为 0.52；与超声心动图为 0.44）。观察到超声心动图和 CMR 测量的 LVL、LVID、IVS 之间存在很强的相关性（r>0.80），与 PW 之间存在中度相关性（r=0.62）。利用 LVL 的强相关性开发了 PLR 模型，该模型在推导队列中显著降低了配对误差（从 64±42 到 22±21 gm）和验证队列中（从 63±46 到 25±18 gm）。此外，它还证明了在两个队列中，绝对误差、相对误差和变异性都显著降低，相关性也更好。在超声心动图和 CMR 之间，LVL 是 LV 尺寸中相关性最好的之一。LVL=2×LVID 的假设似乎不准确。PLR 模型包含 LVL，并显著提高了准确性，降低了 LVM 的变异性。
