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Left Ventricular Mass Quantification by Two-Dimensional Echocardiography in a Pediatric Population: Correlation with Cardiac Magnetic Resonance Imaging

  • Bradford J. Chu
  • Timothy Lee
  • John G. Gilbreth
  • James C. Nielsen
  • Achiau Ludomirsky
  • Justin T. Tretter
  • Puneet Bhatla
Original Article

Abstract

Quantification of left ventricular (LV) mass by echocardiography has not been validated against the gold standard of cardiac magnetic resonance imaging (CMR) in the pediatric population. The purpose of this study was to compare LV mass by two-dimensional and conventional M-mode echocardiography versus CMR in children. Consecutive CMR studies were paired with echocardiograms and retrospectively analyzed in children age ≤ 16 years (3 days old to 16 years old). Studies performed > 3 months between modalities and single ventricle anatomy were excluded. Unindexed LV mass was calculated using M-mode, area-length (AL), and truncated ellipsoid (TE) methods via echocardiography, and compared to cine stack CMR images. There were 46 patients included in the study (both MRI and echocardiography). Good correlations were observed for LV mass measured by CMR and all echocardiographic methods: M-mode (R = 0.965), AL (R = 0.975), and TE (R = 0.975). There was a significant overestimation using TE echocardiography, by a mean of 10.5 g (95% confidence interval 5.7–15.2 g, p < 0.05). There was no significant over- or underestimation of LV mass observed by M-mode or AL echocardiographic measurements, with tight limits of agreement when compared to CMR (95% confidence interval − 5.2 to 4.4 g and − 1.5 to 6.7 g, respectively). Interobserver agreement was good for each of the echocardiographic measurements, but inferior with M-mode (ICC, 0.89) compared to two-dimensional methods (ICC, 0.97). Echocardiographic estimates of LV mass have good correlation with CMR in children. Performance comparison showed AL echocardiographic method provides the most accurate measurement of LV mass with the best reproducibility compared to other methods.

Keywords

Left ventricular mass Left ventricular hypertrophy Echocardiography Cardiac magnetic resonance 

Notes

Acknowledgements

We are indebted to Dr. James C. Nielsen for his critical review and comments of our initial manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Bradford J. Chu
    • 1
  • Timothy Lee
    • 2
  • John G. Gilbreth
    • 1
  • James C. Nielsen
    • 1
  • Achiau Ludomirsky
    • 1
  • Justin T. Tretter
    • 3
  • Puneet Bhatla
    • 1
  1. 1.Division of Pediatric Cardiology, Department of PediatricsNew York University School of MedicineNew YorkUSA
  2. 2.Department of Cardiothoracic SurgeryNew York University School of MedicineNew YorkUSA
  3. 3.Heart InstituteCincinnati Children’s Hospital Medical CenterCincinnatiUSA

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