Discrepancies in Left Ventricular Mass Calculation Based on Echocardiography and Cardiovascular Magnetic Resonance Measurements in Patients with Left Ventricular Hypertrophy
Background Increased left ventricular (LV) mass is associated with adverse cardiovascular outcomes, and its accurate assessment is important. The aim of this study was to analyze the degree of difference among various methods of LV mass calculation based on transthoracic echocardiographic (TTE) meas...
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| creator | Seo, Hee-Young, MD Lee, Seung-Pyo, MD, PhD Park, Jun-Bean, MD Lee, Joo Myung, MD Park, Eun-Ah, MD, PhD Chang, Sung-A, MD, PhD Kim, Hyung-Kwan, MD, PhD Park, Sung-Ji, MD, PhD Lee, Whal, MD, PhD Kim, Yong-Jin, MD, PhD Lee, Sang-Chol, MD, PhD Park, Seung Woo, MD, PhD Sohn, Dae-Won, MD, PhD Choe, Yeon Hyeon, MD, PhD |
| description | Background Increased left ventricular (LV) mass is associated with adverse cardiovascular outcomes, and its accurate assessment is important. The aim of this study was to analyze the degree of difference among various methods of LV mass calculation based on transthoracic echocardiographic (TTE) measurements and cardiovascular magnetic resonance (CMR) measurements, especially in patients with aortic stenosis with varying degrees of LV hypertrophy (LVH). The mechanism underlying this disagreement was also investigated. Methods Ninety-nine patients with moderate to severe aortic stenosis and 33 control subjects matched for age, sex, body weight, and height were enrolled in this prospective observational cohort study. All patients underwent TTE and CMR imaging. LV mass index (LVMI) was calculated using three formulas on the basis of TTE measurements (the Penn-cube, American Society of Echocardiography [ASE], and Teichholz methods) and compared with measurements obtained using CMR, the reference method. Results Although all methods calculated using TTE measurements showed good correlations with CMR measurements, LVMI measured using the Penn-cube and ASE methods tended to be larger than LVMI measured using CMR (difference in LVMI by the Penn-cube and ASE methods, 59.3 ± 29.7 and 30.6 ± 22.3 g/m2 , respectively). This tendency decreased with the Teichholz method (difference in LVMI by the Teichholz method, 22.9 ± 19.1 g/m2 ). The degree of LVMI overestimation was significantly different among the three methods ( P |
| doi_str_mv | 10.1016/j.echo.2015.06.009 |
| format | Article |
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The aim of this study was to analyze the degree of difference among various methods of LV mass calculation based on transthoracic echocardiographic (TTE) measurements and cardiovascular magnetic resonance (CMR) measurements, especially in patients with aortic stenosis with varying degrees of LV hypertrophy (LVH). The mechanism underlying this disagreement was also investigated. Methods Ninety-nine patients with moderate to severe aortic stenosis and 33 control subjects matched for age, sex, body weight, and height were enrolled in this prospective observational cohort study. All patients underwent TTE and CMR imaging. LV mass index (LVMI) was calculated using three formulas on the basis of TTE measurements (the Penn-cube, American Society of Echocardiography [ASE], and Teichholz methods) and compared with measurements obtained using CMR, the reference method. Results Although all methods calculated using TTE measurements showed good correlations with CMR measurements, LVMI measured using the Penn-cube and ASE methods tended to be larger than LVMI measured using CMR (difference in LVMI by the Penn-cube and ASE methods, 59.3 ± 29.7 and 30.6 ± 22.3 g/m2 , respectively). This tendency decreased with the Teichholz method (difference in LVMI by the Teichholz method, 22.9 ± 19.1 g/m2 ). The degree of LVMI overestimation was significantly different among the three methods ( P < .001 by one-way analysis of variance), which was more significant in patients with LVH, especially with the Penn-cube method (differences between CMR and TTE measurements in patients with aortic stenosis and LVH, 66.3 ± 34.8 vs 31.2 ± 26.6 vs 15.5 ± 20.9 g/m2 for the Penn-cube, ASE, and Teichholz methods, respectively; P < .001 with post hoc Tukey analysis). There was a good correlation between LVMI and LV diameter-to-length ratio ( r = 0.468, P < .001), which suggested that the left ventricle takes on a more globular shape with the increase of LVMI, resulting in a significant deviation from the basic assumptions on which the Penn-cube and ASE methods were built. Conclusions Current methods of calculating LVMI from echocardiographic measurements carry a tendency to measure LVMI larger than methods based on CMR measurements, which was more significant in patients with LVH. The change of the left ventricle’s shape with LVH may be a plausible explanation for this, and a correction method may be needed when calculating LVMI from echocardiographic measurements, especially in patients with LVH and smaller body size.</description><identifier>ISSN: 0894-7317</identifier><identifier>EISSN: 1097-6795</identifier><identifier>DOI: 10.1016/j.echo.2015.06.009</identifier><identifier>PMID: 26194306</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aortic stenosis ; Aortic Valve Stenosis - complications ; Aortic Valve Stenosis - diagnosis ; Cardiovascular ; Cardiovascular magnetic resonance ; Case-Control Studies ; Echocardiography ; Echocardiography, Doppler - methods ; Female ; Humans ; Hypertrophy, Left Ventricular - complications ; Hypertrophy, Left Ventricular - diagnosis ; Left ventricular hypertrophy ; Magnetic Resonance Imaging, Cine - methods ; Male ; Middle Aged ; Prospective Studies ; Reference Values ; Sensitivity and Specificity ; Severity of Illness Index</subject><ispartof>Journal of the American Society of Echocardiography, 2015-10, Vol.28 (10), p.1194-1203.e2</ispartof><rights>American Society of Echocardiography</rights><rights>2015 American Society of Echocardiography</rights><rights>Copyright © 2015 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c481t-3c951adde2499da8513841ad8b991d8e2c5e5662bd8fb9067c21b2b8ce3b5e193</citedby><cites>FETCH-LOGICAL-c481t-3c951adde2499da8513841ad8b991d8e2c5e5662bd8fb9067c21b2b8ce3b5e193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.echo.2015.06.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26194306$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Seo, Hee-Young, MD</creatorcontrib><creatorcontrib>Lee, Seung-Pyo, MD, PhD</creatorcontrib><creatorcontrib>Park, Jun-Bean, MD</creatorcontrib><creatorcontrib>Lee, Joo Myung, MD</creatorcontrib><creatorcontrib>Park, Eun-Ah, MD, PhD</creatorcontrib><creatorcontrib>Chang, Sung-A, MD, PhD</creatorcontrib><creatorcontrib>Kim, Hyung-Kwan, MD, PhD</creatorcontrib><creatorcontrib>Park, Sung-Ji, MD, PhD</creatorcontrib><creatorcontrib>Lee, Whal, MD, PhD</creatorcontrib><creatorcontrib>Kim, Yong-Jin, MD, PhD</creatorcontrib><creatorcontrib>Lee, Sang-Chol, MD, PhD</creatorcontrib><creatorcontrib>Park, Seung Woo, MD, PhD</creatorcontrib><creatorcontrib>Sohn, Dae-Won, MD, PhD</creatorcontrib><creatorcontrib>Choe, Yeon Hyeon, MD, PhD</creatorcontrib><title>Discrepancies in Left Ventricular Mass Calculation Based on Echocardiography and Cardiovascular Magnetic Resonance Measurements in Patients with Left Ventricular Hypertrophy</title><title>Journal of the American Society of Echocardiography</title><addtitle>J Am Soc Echocardiogr</addtitle><description>Background Increased left ventricular (LV) mass is associated with adverse cardiovascular outcomes, and its accurate assessment is important. The aim of this study was to analyze the degree of difference among various methods of LV mass calculation based on transthoracic echocardiographic (TTE) measurements and cardiovascular magnetic resonance (CMR) measurements, especially in patients with aortic stenosis with varying degrees of LV hypertrophy (LVH). The mechanism underlying this disagreement was also investigated. Methods Ninety-nine patients with moderate to severe aortic stenosis and 33 control subjects matched for age, sex, body weight, and height were enrolled in this prospective observational cohort study. All patients underwent TTE and CMR imaging. LV mass index (LVMI) was calculated using three formulas on the basis of TTE measurements (the Penn-cube, American Society of Echocardiography [ASE], and Teichholz methods) and compared with measurements obtained using CMR, the reference method. Results Although all methods calculated using TTE measurements showed good correlations with CMR measurements, LVMI measured using the Penn-cube and ASE methods tended to be larger than LVMI measured using CMR (difference in LVMI by the Penn-cube and ASE methods, 59.3 ± 29.7 and 30.6 ± 22.3 g/m2 , respectively). This tendency decreased with the Teichholz method (difference in LVMI by the Teichholz method, 22.9 ± 19.1 g/m2 ). The degree of LVMI overestimation was significantly different among the three methods ( P < .001 by one-way analysis of variance), which was more significant in patients with LVH, especially with the Penn-cube method (differences between CMR and TTE measurements in patients with aortic stenosis and LVH, 66.3 ± 34.8 vs 31.2 ± 26.6 vs 15.5 ± 20.9 g/m2 for the Penn-cube, ASE, and Teichholz methods, respectively; P < .001 with post hoc Tukey analysis). There was a good correlation between LVMI and LV diameter-to-length ratio ( r = 0.468, P < .001), which suggested that the left ventricle takes on a more globular shape with the increase of LVMI, resulting in a significant deviation from the basic assumptions on which the Penn-cube and ASE methods were built. Conclusions Current methods of calculating LVMI from echocardiographic measurements carry a tendency to measure LVMI larger than methods based on CMR measurements, which was more significant in patients with LVH. The change of the left ventricle’s shape with LVH may be a plausible explanation for this, and a correction method may be needed when calculating LVMI from echocardiographic measurements, especially in patients with LVH and smaller body size.</description><subject>Aged</subject><subject>Aortic stenosis</subject><subject>Aortic Valve Stenosis - complications</subject><subject>Aortic Valve Stenosis - diagnosis</subject><subject>Cardiovascular</subject><subject>Cardiovascular magnetic resonance</subject><subject>Case-Control Studies</subject><subject>Echocardiography</subject><subject>Echocardiography, Doppler - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertrophy, Left Ventricular - complications</subject><subject>Hypertrophy, Left Ventricular - diagnosis</subject><subject>Left ventricular hypertrophy</subject><subject>Magnetic Resonance Imaging, Cine - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Reference Values</subject><subject>Sensitivity and Specificity</subject><subject>Severity of Illness Index</subject><issn>0894-7317</issn><issn>1097-6795</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UstuFDEQtBCILIEf4IB85LJD2_OyJYRElkCQNgLxuloeuzfrZdYe7Jmg_Sj-EU824QASvrjdqq6Sq5qQpwwKBqx5sSvQbEPBgdUFNAWAvEcWDGS7bFpZ3ycLELJatiVrT8ijlHYAUAuAh-SEN0xWJTQL8uuNSybioL1xmKjzdI2bkX5DP0Znpl5HeqlToivdz6_RBU_PdEJLc3Ge5Y2O1oWrqIftgWpvM3JuXOt0N33lcXSGfsIUfJZBeok6TRH3WeNG8WOmval_unH7r_7FYcA4xpAFHpMHG90nfHJ7n5Kvb8-_rC6W6w_v3q9er5emEmxclkbWTFuLvJLSalGzUlS5ITopmRXITY110_DOik0noWkNZx3vhMGyq5HJ8pQ8P_IOMfyYMI1qn23Cvtcew5QUa7N_PB_IUH6EmhhSirhRQ3R7HQ-KgZpjUjs1x6TmmBQ0KseUh57d8k_dHu2fkbtcMuDlEYD5l9cOo0o5n2yedRHNqGxw_-d_9de46Z13Rvff8YBpF6bos3-KqcQVqM_zosx7wmqAigtZ_gYImLz_</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Seo, Hee-Young, MD</creator><creator>Lee, Seung-Pyo, MD, PhD</creator><creator>Park, Jun-Bean, MD</creator><creator>Lee, Joo Myung, MD</creator><creator>Park, Eun-Ah, MD, PhD</creator><creator>Chang, Sung-A, MD, PhD</creator><creator>Kim, Hyung-Kwan, MD, PhD</creator><creator>Park, Sung-Ji, MD, PhD</creator><creator>Lee, Whal, MD, PhD</creator><creator>Kim, Yong-Jin, MD, PhD</creator><creator>Lee, Sang-Chol, MD, PhD</creator><creator>Park, Seung Woo, MD, PhD</creator><creator>Sohn, Dae-Won, MD, PhD</creator><creator>Choe, Yeon Hyeon, MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20151001</creationdate><title>Discrepancies in Left Ventricular Mass Calculation Based on Echocardiography and Cardiovascular Magnetic Resonance Measurements in Patients with Left Ventricular Hypertrophy</title><author>Seo, Hee-Young, MD ; Lee, Seung-Pyo, MD, PhD ; Park, Jun-Bean, MD ; Lee, Joo Myung, MD ; Park, Eun-Ah, MD, PhD ; Chang, Sung-A, MD, PhD ; Kim, Hyung-Kwan, MD, PhD ; Park, Sung-Ji, MD, PhD ; Lee, Whal, MD, PhD ; Kim, Yong-Jin, MD, PhD ; Lee, Sang-Chol, MD, PhD ; Park, Seung Woo, MD, PhD ; Sohn, Dae-Won, MD, PhD ; Choe, Yeon Hyeon, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c481t-3c951adde2499da8513841ad8b991d8e2c5e5662bd8fb9067c21b2b8ce3b5e193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aortic stenosis</topic><topic>Aortic Valve Stenosis - complications</topic><topic>Aortic Valve Stenosis - diagnosis</topic><topic>Cardiovascular</topic><topic>Cardiovascular magnetic resonance</topic><topic>Case-Control Studies</topic><topic>Echocardiography</topic><topic>Echocardiography, Doppler - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertrophy, Left Ventricular - complications</topic><topic>Hypertrophy, Left Ventricular - diagnosis</topic><topic>Left ventricular hypertrophy</topic><topic>Magnetic Resonance Imaging, Cine - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Reference Values</topic><topic>Sensitivity and Specificity</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Seo, Hee-Young, MD</creatorcontrib><creatorcontrib>Lee, Seung-Pyo, MD, PhD</creatorcontrib><creatorcontrib>Park, Jun-Bean, MD</creatorcontrib><creatorcontrib>Lee, Joo Myung, MD</creatorcontrib><creatorcontrib>Park, Eun-Ah, MD, PhD</creatorcontrib><creatorcontrib>Chang, Sung-A, MD, PhD</creatorcontrib><creatorcontrib>Kim, Hyung-Kwan, MD, PhD</creatorcontrib><creatorcontrib>Park, Sung-Ji, MD, PhD</creatorcontrib><creatorcontrib>Lee, Whal, MD, PhD</creatorcontrib><creatorcontrib>Kim, Yong-Jin, MD, PhD</creatorcontrib><creatorcontrib>Lee, Sang-Chol, MD, PhD</creatorcontrib><creatorcontrib>Park, Seung Woo, MD, PhD</creatorcontrib><creatorcontrib>Sohn, Dae-Won, MD, PhD</creatorcontrib><creatorcontrib>Choe, Yeon Hyeon, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Society of Echocardiography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Seo, Hee-Young, MD</au><au>Lee, Seung-Pyo, MD, PhD</au><au>Park, Jun-Bean, MD</au><au>Lee, Joo Myung, MD</au><au>Park, Eun-Ah, MD, PhD</au><au>Chang, Sung-A, MD, PhD</au><au>Kim, Hyung-Kwan, MD, PhD</au><au>Park, Sung-Ji, MD, PhD</au><au>Lee, Whal, MD, PhD</au><au>Kim, Yong-Jin, MD, PhD</au><au>Lee, Sang-Chol, MD, PhD</au><au>Park, Seung Woo, MD, PhD</au><au>Sohn, Dae-Won, MD, PhD</au><au>Choe, Yeon Hyeon, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Discrepancies in Left Ventricular Mass Calculation Based on Echocardiography and Cardiovascular Magnetic Resonance Measurements in Patients with Left Ventricular Hypertrophy</atitle><jtitle>Journal of the American Society of Echocardiography</jtitle><addtitle>J Am Soc Echocardiogr</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>28</volume><issue>10</issue><spage>1194</spage><epage>1203.e2</epage><pages>1194-1203.e2</pages><issn>0894-7317</issn><eissn>1097-6795</eissn><abstract>Background Increased left ventricular (LV) mass is associated with adverse cardiovascular outcomes, and its accurate assessment is important. The aim of this study was to analyze the degree of difference among various methods of LV mass calculation based on transthoracic echocardiographic (TTE) measurements and cardiovascular magnetic resonance (CMR) measurements, especially in patients with aortic stenosis with varying degrees of LV hypertrophy (LVH). The mechanism underlying this disagreement was also investigated. Methods Ninety-nine patients with moderate to severe aortic stenosis and 33 control subjects matched for age, sex, body weight, and height were enrolled in this prospective observational cohort study. All patients underwent TTE and CMR imaging. LV mass index (LVMI) was calculated using three formulas on the basis of TTE measurements (the Penn-cube, American Society of Echocardiography [ASE], and Teichholz methods) and compared with measurements obtained using CMR, the reference method. Results Although all methods calculated using TTE measurements showed good correlations with CMR measurements, LVMI measured using the Penn-cube and ASE methods tended to be larger than LVMI measured using CMR (difference in LVMI by the Penn-cube and ASE methods, 59.3 ± 29.7 and 30.6 ± 22.3 g/m2 , respectively). This tendency decreased with the Teichholz method (difference in LVMI by the Teichholz method, 22.9 ± 19.1 g/m2 ). The degree of LVMI overestimation was significantly different among the three methods ( P < .001 by one-way analysis of variance), which was more significant in patients with LVH, especially with the Penn-cube method (differences between CMR and TTE measurements in patients with aortic stenosis and LVH, 66.3 ± 34.8 vs 31.2 ± 26.6 vs 15.5 ± 20.9 g/m2 for the Penn-cube, ASE, and Teichholz methods, respectively; P < .001 with post hoc Tukey analysis). There was a good correlation between LVMI and LV diameter-to-length ratio ( r = 0.468, P < .001), which suggested that the left ventricle takes on a more globular shape with the increase of LVMI, resulting in a significant deviation from the basic assumptions on which the Penn-cube and ASE methods were built. Conclusions Current methods of calculating LVMI from echocardiographic measurements carry a tendency to measure LVMI larger than methods based on CMR measurements, which was more significant in patients with LVH. The change of the left ventricle’s shape with LVH may be a plausible explanation for this, and a correction method may be needed when calculating LVMI from echocardiographic measurements, especially in patients with LVH and smaller body size.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26194306</pmid><doi>10.1016/j.echo.2015.06.009</doi><tpages>10</tpages></addata></record> |
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| subjects | Aged Aortic stenosis Aortic Valve Stenosis - complications Aortic Valve Stenosis - diagnosis Cardiovascular Cardiovascular magnetic resonance Case-Control Studies Echocardiography Echocardiography, Doppler - methods Female Humans Hypertrophy, Left Ventricular - complications Hypertrophy, Left Ventricular - diagnosis Left ventricular hypertrophy Magnetic Resonance Imaging, Cine - methods Male Middle Aged Prospective Studies Reference Values Sensitivity and Specificity Severity of Illness Index |
| title | Discrepancies in Left Ventricular Mass Calculation Based on Echocardiography and Cardiovascular Magnetic Resonance Measurements in Patients with Left Ventricular Hypertrophy |
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