Comparison of two-dimensional echocardiography methods of ventricular volume quantification to cardiovascular magnetic resonance in left ventricular volume overload

- Comparison of 2D TTE left ventricular volume quantification to cardiac MRI
- Various methods compared within the same patient with LV dilation
- 5/6 area-length method was superior to biplane Simpsons and M-mode.
- Biplane Simpsons and M-mode underestimated ventricular dilation

Assessment of left ventricular dilation plays an important role in the management of left ventricular volume overload lesions. Various echocardiographic methods exist, such as the 5/6 area-length and biplane Simpsons, but their agreement with cardiac magnetic resonance imaging in patients with chronic left ventricular volume overload from a young age has not been assessed. This was a retrospective review of patients with moderate or worse aortic regurgitation, mitral regurgitation, or ventricular septal defect who underwent both studies within 6 months. End-diastolic and systolic volumes and dimensions were measured by echocardiography using the 5/6 area-length, biplane Simpsons, and M-mode methods, and compared to cardiac MRI-derived volumes. The 5/6 area-length method showed the best agreement with MRI and remained consistent with increasing ventricular dilation. The biplane Simpsons and M-mode-based Teichholz method underestimated ventricular dilation and performed worse with increasing dilation. When comparing ventricular dimensions by M-mode, there was a non-linear relationship between linear dimension and MRI-derived volume. Linear dimension appeared to plateau with increasing ventricular dilation, leading to underestimation in severity of dilation. The 5/6 area-length method was superior to other echocardiographic methods of ventricular volume quantification when compared with MRI.