Evaluation of left atrial volume and function using single-beat real-time three-dimensional echocardiography in atrial fibrillation patients

BackgroundThis study was aimed to evaluate the feasibility and accuracy of real-time three-dimensional echocardiography (RT-3DE) measurement of left atrial (LA) volume and function in comparison with two-dimensional echocardiography (2DE) measurements in atrial fibrillation (AF) patients.MethodsA total of 50 pairs of AF patients and healthy controls were enrolled in this study. Indexed LA end-diastole volume (ILAEDV) and indexed LA end-systolic volume (ILAESV), as well as LA function indices such as segmental LA ejection fraction (LAEF), were assessed using 2DE Simpson’s method and the RT-3DE method.ResultsThe images showed that regional LA volume–time curves and LAEF were disordered in AF patients. ILAEDV and ILAESV were markedly increased and global LAEF was significantly decreased in AF patients compared with those in healthy controls (P < 0.01). No significant differences were found in ILAEDV, ILAESV, and LAEF levels as determined by the RT-3DE method or 2DE Simpson’s method. Bland–Altman analysis showed that the two methods agreed well for measuring ILAEDV, ILAESV, and segmental LAEF.ConclusionThe RT-3DE method may be a feasible and accurate method for evaluating LA volume and function of AF patients in clinical practice.

[1]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[2]  T. Marwick,et al.  Reproducibility and accuracy of echocardiographic measurements of left ventricular parameters using real-time three-dimensional echocardiography. , 2004, Journal of the American College of Cardiology.

[3]  N. Reichek,et al.  Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. , 1989, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[4]  Jonathan Chan,et al.  Comparison of two- and three-dimensional echocardiography with sequential magnetic resonance imaging for evaluating left ventricular volume and ejection fraction over time in patients with healed myocardial infarction. , 2007, The American journal of cardiology.

[5]  J B Seward,et al.  Left atrial volume: important risk marker of incident atrial fibrillation in 1655 older men and women. , 2001, Mayo Clinic proceedings.

[6]  H C Smith,et al.  Left ventricular dysfunction due to atrial fibrillation in patients initially believed to have idiopathic dilated cardiomyopathy. , 1992, The American journal of cardiology.

[7]  S. Kim,et al.  Multi-modality imaging for the assessment of myocardial perfusion with emphasis on stress perfusion CT and MR imaging , 2015, The International Journal of Cardiovascular Imaging.

[8]  James B Seward,et al.  Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women. , 2002, Journal of the American College of Cardiology.

[9]  Jeroen J. Bax,et al.  Real-time three dimensional echocardiography: current and future clinical applications , 2009, Heart.

[10]  Lesley H. Curtis,et al.  Incidence and Prevalence of Atrial Fibrillation and Associated Mortality Among Medicare Beneficiaries: 1993–2007 , 2012, Circulation. Cardiovascular quality and outcomes.

[11]  Surya M. Artham Feigenbaum's Echocardiography , 2010 .

[12]  C L Feldman,et al.  Assessment of Left Ventricular Ejection Fraction and Volumes by Real-time, Two-dimensional Echocardiography: A Comparison of Cineangiographic and Radionuclide Techniques , 1979, Circulation.

[13]  B. Hoit,et al.  Left atrial size and function: role in prognosis. , 2014, Journal of the American College of Cardiology.

[14]  Dr.William F Armstrong Comprar Feigenbaum's Echocardiography 7/e | Dr.William F Armstrong MD | 9780781795579 | Lippincott Williams & Wilkins , 2010 .

[15]  D J Pennell,et al.  Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, radionuclide ventriculography and cardiovascular magnetic resonance; are they interchangeable? , 2000, European heart journal.

[16]  Saibal Kar,et al.  Comparison of real-time three-dimensional transesophageal echocardiography to two-dimensional transesophageal echocardiography for quantification of mitral valve prolapse in patients with severe mitral regurgitation. , 2013, The American journal of cardiology.

[17]  Christos V. Bourantas,et al.  Clinical significance of left atrial ejection fraction measured by MRI in patients with suspected heart failure , 2013 .

[18]  Juan F Granada,et al.  A population-based study of mortality among patients with atrial fibrillation or flutter. , 2002, The American journal of medicine.

[19]  M. Haissaguerre,et al.  Left Ventricular Diastolic Dysfunction in Patients with So‐Called Lone Atrial Fibrillation , 2000, Journal of cardiovascular electrophysiology.

[20]  Andrea Barbieri,et al.  Indexed left atrial volume predicts the recurrence of non-valvular atrial fibrillation after successful cardioversion. , 2011, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[21]  Katja Zeppenfeld,et al.  Comparison of left atrial volumes and function by real-time three-dimensional echocardiography in patients having catheter ablation for atrial fibrillation with persistence of sinus rhythm versus recurrent atrial fibrillation three months later. , 2008, The American journal of cardiology.

[22]  H RICHARD,et al.  Mole B. A. Lond., M. D. Lpool. , 1952, Lancet.

[23]  Juan Cong,et al.  Quantitative analysis of left atrial volume and function during normotensive and preeclamptic pregnancy: a real-time three-dimensional echocardiography study , 2015, The International Journal of Cardiovascular Imaging.

[24]  G T LESSER,et al.  Mercurial Diuresis in Edematous Individuals , 1952, Circulation.

[25]  Jeroen J. Bax,et al.  Accuracy of three-dimensional versus two-dimensional echocardiography for quantification of aortic regurgitation and validation by three-dimensional three-directional velocity-encoded magnetic resonance imaging. , 2013, The American journal of cardiology.

[26]  Yuchi Han,et al.  Left Atrial Volume Best Predicts Recurrence after Catheter Ablation in Patients with Persistent and Longstanding Persistent Atrial Fibrillation , 2014, Pacing and clinical electrophysiology : PACE.

[27]  Vincenzo Malavasi,et al.  Indexed Left Atrial Volume Is Superior to Left Atrial Diameter in Predicting Nonvalvular Atrial Fibrillation Recurrence after Successful Cardioversion: A Prospective Study , 2012, Echocardiography.

[28]  Attila Nemes,et al.  [The role of real-time three-dimensional echocardiography in the evaluation of hypertrophic cardiomyopathy]. , 2009, Orvosi hetilap.

[29]  L R Llerena,et al.  Comparison of segmental and global ejection fraction in ischaemic heart disease. , 1985, Cor et vasa.

[30]  Hiroki Takahashi,et al.  Abstract 16303: Left Atrial Ejection Fraction is a Feasible Parameter to Predict Poor Prognosis in Patients with Heart Failure and Sinus Rhythm , 2012 .

[31]  S. Vaziri,et al.  Echocardiographic Predictors of Nonrheumatic Atrial Fibrillation: The Framingham Heart Study , 1994, Circulation.