Key result
2D echocardiography overestimates pediatric LVEF by ~8% compared to CMR while underestimating ventricular volumes.
Why the study?
There is no consensus on the most accurate echocardiographic method of quantifying ventricular volumes and systolic function in the pediatric population.
Do the five-sixth area-length and modified biplane Simpson echocardiographic methods accurately measure left ventricular volume and ejection fraction compared to cardiac magnetic resonance imaging in children?
Observational (n=46)
Blinded to other modality results
No
Do the five-sixth area-length and modified biplane Simpson echocardiographic methods accurately measure left ventricular volume and ejection fraction compared to cardiac magnetic resonance imaging in children?
Mean Difference: 7
p-value: p=<0.01
Echocardiography systematically overestimates left ventricular ejection fraction and underestimates left ventricular volumes compared to cardiac magnetic resonance imaging in pediatric patients, suggesting CMR should be considered when accurate measurements are critical.
Echocardiographic LVEF estimates warrant caution in children; leaves open when CMR is needed for precise decisions.
Background: Echocardiographic quantification of left ventricular (LV) volume and ejection fraction (EF) is widely used in the pediatric population. However, there is no consensus on the most accurate method of quantifying ventricular volumes and systolic function. Purpose: The purpose of this study is to compare two commonly used echocardiographic methods for the evaluation of LV volume and quantification of EF, the five-sixth area-length (5/6 AL) and the modified biplane Simpson (BS), to cardiac magnetic resonance (CMR) imaging in children. Methods: CMR studies were paired with echocardiograms and retrospectively analyzed in children 18 years of age and younger. Studies performed more than 3 months between modalities, patients with congenital heart disease, and patients who had changes in medication regimen between corresponding CMR and echocardiograms were excluded. LV volumes and EF were calculated using the 5/6 AL and BS methods and compared to volumes and EF measured on corresponding CMR studies. Subgroup analyses were conducted based on LV function, pathology, and weight. Results: = 0.82). However, both echocardiographic methods overestimated LVEF and underestimated LV volumes when compared to CMR. Conclusion: Left ventricular volumes and EF, as measured by echocardiography, correlate well with CMR measurements. Echocardiography underestimates LV systolic and diastolic volumes and overestimates LVEF. While echocardiography is a good surrogate for estimating LVEF, CMR should be considered in patients for whom accurate measurements are needed for critical clinical decision-making.
No takes yet. Share an insight, caveat, or question.
Bhansali et al. (2024) conducted an observational in Acquired heart disease (myocarditis and cardiomyopathy) (n=46). Two-dimensional echocardiography (5/6 area-length and modified biplane Simpson methods) vs. Cardiac magnetic resonance (CMR) imaging was evaluated on Left ventricular ejection fraction (LVEF) compared to CMR (Mean difference 7.0% (5/6 AL) and 8.3% (BS), p=<0.01). Two-dimensional echocardiography systematically overestimated left ventricular ejection fraction by 7.0-8.3% and underestimated ventricular volumes compared to cardiac magnetic resonance in children.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: