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Automated quantification of left atrial size using three-beat averaging real-time three dimensional Echocardiography in patients with atrial fibrillation

 Ran Heo  ;  Geu-Ru Hong  ;  Young-Jin Kim  ;  Joel Mancina  ;  In-Jeong Cho  ;  Chi Young Shim  ;  Hyuk-Jae Chang  ;  Jong-Won Ha  ;  Namsik Chung 
Journal Title
Issue Date
Aged ; Algorithms ; Atrial Fibrillation/diagnostic imaging* ; Computer Systems ; Data Interpretation, Statistical ; Echocardiography, Three-Dimensional/methods* ; Feasibility Studies ; Female ; Heart Atria/diagnostic imaging* ; Humans ; Image Enhancement/methods ; Image Interpretation, Computer-Assisted/methods* ; Imaging, Three-Dimensional/methods* ; Male ; Middle Aged ; Organ Size ; Pattern Recognition, Automated/methods* ; Reproducibility of Results ; Sensitivity and Specificity
Three-dimensional echocardiography ; Left atrial volume ; Atrial fibrillation
BACKGROUND: Left atrial (LA) sizing in patients with atrial fibrillation (AF) is crucial for follow-up and outcome. Recently, the automated quantification of LA using the novel three-beat averaging real-time three dimensional echocardiography (3BA-RT3DE) is introduced. The aim of this study was to assess the feasibility and accuracy of 3BA-RT3DE in patients with atrial fibrillation (AF). METHODS: Thirty-one patients with AF (62.8 ± 11.7 years, 67.7 % male) were prospectively recruited to have two dimensional echocardiography (2DE) and 3BA-RT3DE (SC 2000, ACUSON, USA). The maximal left atrial (LA) volume was measured by the conventional prolate-ellipse (PE) and area-length (AL) method using three-beat averaging 2D transthoracic echocardiography and automated software analysis (eSie volume analysis, Siemens Medical Solution, Mountain view, USA); measurements were compared with those obtained by computed tomography (CT). RESULTS: Maximal LA volume by 3BA-RT3DE was feasible for all patients. LA volume was 68.4 ± 28.2 by PE-2DE, 89.2 ± 33.1 by AL-2DE, 100.6 ± 31.8 by 3BA-RT3DE, and 131.2 ± 42.2 mL by CT. LA volume from PE-2DE (R(2) = 0.48, p < 0.001, ICC = 0.64, p < 0.001), AL-2DE (R(2) = 0.47, p < 0.001, ICC = 0.67, p < 0.001), and 3BA-RT3DE (R(2) = 0.50, p = 0.001, ICC = 0.65, p < 0.001) showed significant correlations with CT. However, 3BA-RT3DE demonstrated a small degree of underestimation (30.5 mL) of LA volume compared to 2DE-based measurements. Good-quality images from 3BA-RT3DE (n = 16) showed a significantly tighter correlation with images from CT scanning (R(2) = 0.60, p = 0.0004, ICC = 0.76, p < 0.001) compared to those of fair quality. CONCLUSION: Automated quantification of LA volume using 3BA-RT3DE is feasible and accurate in patients with AF. An image of good quality is essential for maximizing the value of this method in clinical practice.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Chung, Nam Sik(정남식)
Cho, In Jeong(조인정)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Heo, Ran(허란)
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
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