Author + information
- Received September 4, 1993
- Revision received January 27, 1994
- Accepted March 11, 1994
- Published online August 1, 1994.
- Aasha S. Gopal, MDa,∗,
- Andrew M. Keller, MD, FACC∗,
- Zhanqing Shen, MDa,
- Peter M. Sapin, MD†,
- Klaus M. Schroeder, MD‡,
- Donald L. King Jr., MSa,1 and
- Donald L. King, MDa
- ↵∗Address for correspondence: Dr. Aasha S. Gopal, Columbia University, Division of Cardiology, Atchley Pavilion 552, 161 Fort Washington Avenue, New York, New York 10032.
Objectives. This study aimed to validate a method for mass computation in vitro and in vivo and to compare it with conventional methods.
Background. Conventional echocardiographic methods of determining left ventricular mass are limited by assumptions of ventricular geometry and image plane positioning. To improve accuracy, we developed a three-dimensional echocardiographic method that uses nonparallel, nonintersecting short-axis planes and a polyhedral surface reconstruction algorithm for mass computation.
Methods. Eleven fixed hearts were imaged by three-dimensional echocardiography, and mass was determined in vitro by multiplying the myocardial volume by the density of each heart and comparing it with the true mass. Mass at diastole and systole by three-dimensional echocardiography and magnetic resonance imaging (MRI) was compared in vivo in 15 normal subjects. Ten subjects also underwent imaging by one- and two-dimensional echocardiography, and mass was determined by Penn convention, area-length and truncated ellipsoid algorithms.
Results. In vitro results were r = 0.995, SEE 2.91 g, accuracy 3.47%. In vivo interobserver variability for systole and diastole was 16.7% to 27%, 14% to 18.1% and 6.3% to 12.8%, respectively, for one-, two- and three-dimensional echocardiography and was 7.5% for MRI at end-diastole. The latter two agreed closely with regard to diastolic mass (r = 0.895, SEE 11.1 g) and systolic mass (r = 0.926, SEE 9.2 g). These results were significantly better than correlations between MRI and the Penn convention (r = 0.725, SEE 25.6 g for diastole; r = 0.788, SEE 28.7 g for systole), area-length (r = 0.694, SEE 24.2 g for diastole; r = 0.717, SEE 28.2 g for systole) and truncated ellipsoid algorithms (r = 0.687, SEE 21.8 g for diastole; r = 0.710, SEE 24.5 g for systole).
Conclusions. Image plane positioning guidance and elimination of geometric assumptions by three-dimensional echocardiography achieve high accuracy for left ventricular mass determination in vitro. It is associated with higher correlations and lower standard errors than conventional methods in vivo.
↵1 Development of the three-dimensional echocardiographic system used in this study has been financed by Dr. King using personal funds. He controls K3 Systems, Inc., Darien, Connecticut, a corporation through which this system is marketed. His coauthors have no financial interest in the development of the system or in K3 Systems, Inc.
☆ This study was presented in part at the 64th Scientific Sessions of the American Heart Association, Anaheim, California, November 1991; the 42nd Annual Scientific Session of the American College of Cardiology, Anaheim, California, March 1993; the Fourth Annual Scientific Meeting of the American Society of Echocardiography, Orlando, Florida, June 1993; the American Heart Association Council for High Blood Pressure Research 47th Annual Fall Conference and Scientific Sessions, San Francisco, California, September/October 1993. This work was supported by Principal Investigatorship and Grant-in-Aid awards from the American Heart Association, New York City affiliate.
- Received September 4, 1993.
- Revision received January 27, 1994.
- Accepted March 11, 1994.