- Poster presentation
- Open Access
Left atrial dilation in patients with heart failure and preserved ejection fraction: Value of CMR Simpson method
© Vassiliou et al. 2016
- Published: 27 January 2016
- Atrial Fibrillation
- Sinus Rhythm
- Left Atrial
- Intraclass Correlation Coefficient
- Left Atrial Volume
Left atrial (LA) dilation is an important prognostic indicator in heart failure. CMR provides the gold standard for LA volume estimation using the volumetric short axis Simpson method. However, this requires the acquisition of additional images with breatholding which can be difficult in patients with heart failure. We investigated whether volume calculated by the biplane area-length method from CMR and echocardiography were appropriate alternatives in a cohort of patients with heart failure and preserved ejection fraction (HFpEF).
25 patients with HFpEF (age 74 ± 6 years, 15 male) underwent up to 3 CMR and 3 echocardiography studies each giving a total of 72 scans for each modality. CMR and echo were undertaken the same day. SSFP cine imaging with contiguous stack of short-axis images across the LA was taken to calculate LA volume using Simpson method. Standard 2 chamber and 4 chamber were also obtained to calculate LA volume using biplane area-length method from both CMR and echo. The biplane area-length method volume was calculated using the equation 8/3π*A1*A2*L where A1 and A2 were the areas in the 2 and 4 chamber and L was the shortest linear measurement parallel to the atrial septum in the 2 or 4 chamber view.
72 studies were performed in total. 43 studies were performed during Atrial Fibrillation (AF), and 29 in sinus rhythm (SR). The absolute LA volumes using the three methods with the standard deviation are shown in Figure 1. Compared to the volumetric short axis technique, the echo area-length method underestimated LA volume in both SR (p=0.0009) and AF (p=<0.0001). CMR area-length showed a trend to overestimation of the LA volume in SR (p=0.053) but not in AF (p=0.927).
In a cohort of patients with HFpEF, CMR area-length method for estimating LA volume in both SR and AF correlated and agreed well with the gold standard CMR Simpson LA volumetric stack method. This suggests that in patients with HFpEF area-length volume calculation of LA is reliable and can be considered to shorten scan duration. Echocardiographic data, especially in AF, appeared less accurate.
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