Accuracy of Echocardiographic Area-length Method in Chronic Myocardial Infarction: Comparison with Cardiac CT in Pigs

Overview

Journal Cardiovasc Ultrasound

Publisher Biomed Central

Specialties Cardiology & Vascular Diseases
Radiology

Date 2017 Jan 11

PMID 28069008

Authors

Haitham Ballo

Miikka Tarkia

Matti Haavisto

Christoffer Stark

Marjatta Strandberg

Tommi Vahasilta

Virva Saunavaara

Tuula Tolvanen

Mika Teras

Ville-Veikko Hynninen

Timo Savunen

Anne Roivainen

Juhani Knuuti

Antti Saraste

Affiliations

Soon will be listed here.

Abstract

Background: We evaluated echocardiographic area-length methods to measure left ventricle (LV) volumes and ejection fraction (EF) in parasternal short axis views in comparison with cardiac computed tomography (CT) in pigs with chronic myocardial infarction (MI).

Methods: Male farm pigs with surgical occlusion of the left anterior descending coronary artery (n = 9) or sham operation (n = 5) had transthoracic echocardiography and cardiac-CT 3 months after surgery. We measured length of the LV in parasternal long axis view, and both systolic and diastolic LV areas in parasternal short axis views at the level of mitral valve, papillary muscles and apex. Volumes and EF of the LV were calculated using Simpson's method of discs (tri-plane area) or Cylinder-hemiellipsoid method (single plane area).

Results: The pigs with coronary occlusion had anterior MI scars and reduced EF (average EF 42 ± 10%) by CT. Measurements of LV volumes and EF were reproducible by echocardiography. Compared with CT, end-diastolic volume (EDV) measured by echocardiography showed good correlation and agreement using either Simpson's method (r = 0.90; mean difference -2, 95% CI -47 to 43 mL) or Cylinder-hemiellipsoid method (r = 0.94; mean difference 3, 95% CI -44 to 49 mL). Furthermore, End-systolic volume (ESV) measured by echocardiography showed also good correlation and agreement using either Simpson's method (r = 0.94; mean difference 12 ml, 95% CI: -16 to 40) or Cylinder-hemiellipsoid method (r = 0.97; mean difference:13 ml, 95% CI: -8 to 33). EF was underestimated using either Simpson's method (r = 0.78; mean difference -6, 95% CI -11 to 1%) or Cylinder-hemiellipsoid method (r = 0.74; mean difference -4, 95% CI-10 to 2%).

Conclusion: Our results indicate that measurement of LV volumes may be accurate, but EF is underestimated using either three or single parasternal short axis planes by echocardiography in a large animal model of chronic MI.

References

Gardner B, Bingham S, Allen M, Blatter D, Anderson J . Cardiac magnetic resonance versus transthoracic echocardiography for the assessment of cardiac volumes and regional function after myocardial infarction: an intrasubject comparison using simultaneous intrasubject recordings. Cardiovasc Ultrasound. 2009; 7:38. PMC: 2743646. DOI: 10.1186/1476-7120-7-38. View

Picard M, Popp R, Weyman A . Assessment of left ventricular function by echocardiography: a technique in evolution. J Am Soc Echocardiogr. 2008; 21(1):14-21. DOI: 10.1016/j.echo.2007.11.007. View

Wyatt H, Heng M, Meerbaum S, Hestenes J, Cobo J, Davidson R . Cross-sectional echocardiography. I. Analysis of mathematic models for quantifying mass of the left ventricle in dogs. Circulation. 1979; 60(5):1104-13. DOI: 10.1161/01.cir.60.5.1104. View

Nosir Y, Vletter W, Boersma E, Frowijn R, Ten Cate F, Fioretti P . The apical long-axis rather than the two-chamber view should be used in combination with the four-chamber view for accurate assessment of left ventricular volumes and function. Eur Heart J. 1997; 18(7):1175-85. DOI: 10.1093/oxfordjournals.eurheartj.a015414. View

Wyatt H, Heng M, Meerbaum S, Gueret P, Hestenes J, Dula E . Cross-sectional echocardiography. II. Analysis of mathematic models for quantifying volume of the formalin-fixed left ventricle. Circulation. 1980; 61(6):1119-25. DOI: 10.1161/01.cir.61.6.1119. View

Bellenger N, Burgess M, Ray S, Lahiri A, Coats A, Cleland J . Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, radionuclide ventriculography and cardiovascular magnetic resonance; are they interchangeable?. Eur Heart J. 2000; 21(16):1387-96. DOI: 10.1053/euhj.2000.2011. View

Tarkia M, Stark C, Haavisto M, Kentala R, Vahasilta T, Savunen T . Cardiac remodeling in a new pig model of chronic heart failure: Assessment of left ventricular functional, metabolic, and structural changes using PET, CT, and echocardiography. J Nucl Cardiol. 2015; 22(4):655-65. DOI: 10.1007/s12350-015-0068-9. View

Gueret P, Meerbaum S, Wyatt H, Uchiyama T, LANG T, CORDAY E . Two-dimensional echocardiographic quantitation of left ventricular volumes and ejection fraction. Importance of accounting for dyssynergy in short-axis reconstruction models. Circulation. 1980; 62(6):1308-18. DOI: 10.1161/01.cir.62.6.1308. View

Folland E, Parisi A, Moynihan P, Jones D, Feldman C, TOW D . Assessment of left ventricular ejection fraction and volumes by real-time, two-dimensional echocardiography. A comparison of cineangiographic and radionuclide techniques. Circulation. 1979; 60(4):760-6. DOI: 10.1161/01.cir.60.4.760. View

10.

Lang R, Badano L, Mor-Avi V, Afilalo J, Armstrong A, Ernande L . Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015; 16(3):233-70. DOI: 10.1093/ehjci/jev014. View

11.

Chukwu E, Barasch E, Mihalatos D, Katz A, Lachmann J, Han J . Relative importance of errors in left ventricular quantitation by two-dimensional echocardiography: insights from three-dimensional echocardiography and cardiac magnetic resonance imaging. J Am Soc Echocardiogr. 2008; 21(9):990-7. DOI: 10.1016/j.echo.2008.07.009. View

12.

Wyatt H, Meerbaum S, Heng M, Gueret P, CORDAY E . Cross-sectional echocardiography. III. Analysis of mathematic models for quantifying volume of symmetric and asymmetric left ventricles. Am Heart J. 1980; 100(6 Pt 1):821-8. DOI: 10.1016/0002-8703(80)90062-9. View

13.

Greupner J, Zimmermann E, Grohmann A, Dubel H, Althoff T, Althoff T . Head-to-head comparison of left ventricular function assessment with 64-row computed tomography, biplane left cineventriculography, and both 2- and 3-dimensional transthoracic echocardiography: comparison with magnetic resonance imaging as the.... J Am Coll Cardiol. 2012; 59(21):1897-907. DOI: 10.1016/j.jacc.2012.01.046. View

14.

Helak J, Reichek N . Quantitation of human left ventricular mass and volume by two-dimensional echocardiography: in vitro anatomic validation. Circulation. 1981; 63(6):1398-407. DOI: 10.1161/01.cir.63.6.1398. View