Evaluation of left ventricular mass measured by 3D echocardiography using magnetic resonance imaging as gold standard

Abstract

Objective. Increased left ventricular mass (LVM) and presence of left ventricular hypertrophy (LVH) are predictors of cardiovascular morbidity and mortality, but can be reversed with proper treatment of the underlying cause. Therefore accurate as well as reproducible methods for diagnosis and follow‐up are needed. We evaluated different modalities by which to measure LVM in patients with no known LVH using magnetic resonance imaging (MRI) as the gold standard: ECG using the formulae proposed by Sokolow‐Lyon and Cornell, 2D echocardiography and 3D echocardiography. Methods. 34 subjects were included in the study; 17 had a history of myocardial infarction, 7 had pulmonary hypertension and 10 were healthy. All patients and controls had a standard 12‐lead ECG, a transthoracic 2D and 3D echocardiographic study and a cardiac MRI. Results. ECG estimates of LVM correlated poorly with LVM by MRI (r = 0.18, NS and 0.16, NS for Sokolow‐Lyon and Cornell, respectively), whereas a moderate correlation between 2D and 3D echocardiography and MRI was observed (r = 0.63, p<0.001 and r = 0.74, p<0.001, respectively). All methods were reproducible with no significant bias. Conclusion. LVM measured by 3D echocardiography is highly accurate compared to LVM measured by MRI. LVM calculated from 2D echocardiography also proved useful, whereas estimates of LVM by ECG are inaccurate in a non‐hypertrophic population.

• 2D echocardiography
• 3D echocardiography
• electrocardiography
• left ventricular hypertrophy
• left ventricular mass
• magnetic resonance imaging

Acknowledgements

Research nurse Ane Loof Johansen is acknowledged for her help with the collection of data. The Danish Heart Foundation supported the research fellowship of Dr. Kjaergaard, grant no. 04‐10‐B109‐A166‐22192