Circulation, Vol 67, 348-352, Copyright © 1983 by American Heart Association
N Reichek, J Helak, T Plappert, MS Sutton and KT Weber
We performed a prospective anatomic validation study to determine the
accuracy of left ventricular (LV) mass estimates from clinical two-
dimensional echocardiographic (2-D echo) studies. In 21 subjects,
antemortem 2-D echo LV mass determinations were compared with anatomic LV
weight by postmortem chamber dissection. Major cardiac diagnoses included
anatomic LV aneurysm in four, status post aneurysmectomy in one, transmural
myocardial infarction in seven, congestive cardiomyopathy in five,
rheumatic mitral disease in two, chronic severe mitral or aortic
regurgitation in three, amyloid heart in two, and normal heart in three.
Marked right-heart dilatation was present in 11 patients and LV thrombus in
four. Regression equations derived in vitro for each 2-D echo instrument
were used to correct LV mass estimates based on a short-axis, area-length
method: uncorrected LV mass = 1.055 x k x 5/6 (AtLt - AcLc) + b, where At =
total short-axis LV image area at the high papillary muscle level, Lc =
endocardial LV length, k = an instrument-specific regression slope and b =
an instrument-specific intercept. LV mass by 2-D echo correlated extremely
well with actual LV weight (r = 0.93 slope = 0.85, SEE = 31 g, range 77-454
g). In contrast, M-mode echocardiographic LV mass estimates were less
reliable (r = 0.86, SEE = 59 g) in these markedly distorted hearts. These
2-D echo LV mass results compare favorably with reported results from
biplane angiography and M-mode echocardiography in more symmetric hearts.
Thus, regression-corrected 2-D echo may be the method of choice for
determining LV mass in man.
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Anatomic validation of left ventricular mass estimates from clinical two-dimensional echocardiography: initial results
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