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Open Access 01-12-2015 | Research

Automated quantification of left atrial size using three-beat averaging real-time three dimensional Echocardiography in patients with atrial fibrillation

Authors: Ran Heo, Geu-Ru Hong, Young-Jin Kim, Joel Mancina, In-Jeong Cho, Chi Young Shim, Hyuk-Jae Chang, Jong-Won Ha, Namsik Chung

Published in: Cardiovascular Ultrasound | Issue 1/2015

Abstract

Background

Left atrial (LA) sizing in patients with atrial fibrillation (AF) is crucial for follow-up and outcome. Recently, the automated quantification of LA using the novel three-beat averaging real-time three dimensional echocardiography (3BA-RT3DE) is introduced. The aim of this study was to assess the feasibility and accuracy of 3BA-RT3DE in patients with atrial fibrillation (AF).

Methods

Thirty-one patients with AF (62.8 ± 11.7 years, 67.7 % male) were prospectively recruited to have two dimensional echocardiography (2DE) and 3BA-RT3DE (SC 2000, ACUSON, USA). The maximal left atrial (LA) volume was measured by the conventional prolate-ellipse (PE) and area-length (AL) method using three-beat averaging 2D transthoracic echocardiography and automated software analysis (eSie volume analysis, Siemens Medical Solution, Mountain view, USA); measurements were compared with those obtained by computed tomography (CT).

Results

Maximal LA volume by 3BA-RT3DE was feasible for all patients. LA volume was 68.4 ± 28.2 by PE-2DE, 89.2 ± 33.1 by AL-2DE, 100.6 ± 31.8 by 3BA-RT3DE, and 131.2 ± 42.2 mL by CT. LA volume from PE-2DE (R² = 0.48, p < 0.001, ICC = 0.64, p < 0.001), AL-2DE (R² = 0.47, p < 0.001, ICC = 0.67, p < 0.001), and 3BA-RT3DE (R² = 0.50, p = 0.001, ICC = 0.65, p < 0.001) showed significant correlations with CT. However, 3BA-RT3DE demonstrated a small degree of underestimation (30.5 mL) of LA volume compared to 2DE-based measurements. Good-quality images from 3BA-RT3DE (n = 16) showed a significantly tighter correlation with images from CT scanning (R² = 0.60, p = 0.0004, ICC = 0.76, p < 0.001) compared to those of fair quality.

Conclusion

Automated quantification of LA volume using 3BA-RT3DE is feasible and accurate in patients with AF. An image of good quality is essential for maximizing the value of this method in clinical practice.

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Title: Automated quantification of left atrial size using three-beat averaging real-time three dimensional Echocardiography in patients with atrial fibrillation
Authors: Ran Heo
Geu-Ru Hong
Young-Jin Kim
Joel Mancina
In-Jeong Cho
Chi Young Shim
Hyuk-Jae Chang
Jong-Won Ha
Namsik Chung
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Cardiovascular Ultrasound / Issue 1/2015
Electronic ISSN: 1476-7120
DOI: https://doi.org/10.1186/s12947-015-0032-5

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