Why the study?
Does real-time 3D echocardiography provide repeatable and agreeable measurements of left ventricular mass and synchrony compared to M-mode in young patients?
Does real-time 3D echocardiography provide repeatable and agreeable measurements of left ventricular mass and synchrony compared to M-mode in young patients?
While 3D and M-mode echocardiography both provide highly repeatable measurements of left ventricular mass, wide limits of agreement between the methods dictate that the same technique should be used consistently during patient follow-up.
Caution against interchanging 3D and M-mode LVM measurements during young patient follow-up; extends reproducibility data while leaving comparative utility open.
BACKGROUND: Left ventricular mass (LVM) and synchrony have prognostic value for many cardiovascular disease states. We report the agreement and repeatability of LVM estimation by three-dimensional (3D) versus M-mode and repeatability of 3D estimation of systolic dyssynchrony. METHODS: 3DLVM was computed by subtraction of endocardial from epicardial volume X1.05 both at end-diastole and end-systole. M-mode measurements were made at end-diastole. This prospective study comprised 40 subjects, 20 patients with chronic kidney disease or treated neuroblastoma and 20 healthy individuals. The median age was 17 (range 6-29 years). RESULTS: Intra- and inter-observer intraclass correlation was excellent for 3D systolic LVM (0.99, 0.87), 3D diastolic LVM (0.99, 0.93), M-mode LVM (0.88, 0.93), moderate for 16-segment SDI (0.77, 062), moderate to low for 12-segment SDI (0.48, 0.73), and 6-segment SDI (0.37, 0.69). The median (range) LVM measurement for 3D diastolic LVM was 125 g (50-253), 3D systolic LVM 109 g (40-195), and M-mode LVM 115 g (range 40-207). There was a significant bias for diastolic 3DLVM to be higher than systolic 3D or M-mode. Limits of agreement between methods were wide. The median (range) systolic dyssynchrony measurements were 2.0 (0.4-7.0), 1.5 (0.3-4.3), and 1.4 (0.3-4.5) for 16-segment, 12-segment, and 6-segment models, respectively. CONCLUSION: 3D and M-mode measurement of LVM are highly repeatable. Measurement bias and wide limits of agreement mean that the same echocardiographic technique should be used during follow-up. Measurement of 3D systolic dyssynchrony is most repeatable using a 16-segment model.
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Ojala et al. (2014) studied this question.
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