Abstract
OBJECTIVE—To assess the dynamic changes in left atrial volume by transthoracic three dimensional echocardiography and compare the results with those obtained by magnetic resonance imaging (MRI). DESIGN AND PATIENTS—30 healthy children (15 boys and 15 girls, aged 8 to 13 years) underwent examination by three dimensional echocardiography and MRI. METHODS—Three dimensional echocardiography of the left atrium was performed using rotational acquisition of planes at 18° intervals from the parasternal window with ECG gating and without respiratory gating. Volume estimation by MRI was performed with a slice thickness of 4-8 mm and ECG triggering during breath holding in deep inspiration. A left atrial time-volume curve was reconstructed in each child. RESULTS—Left atrial maximum and minimum volumes averaged 24.0 ml/m2 and 7.6 ml/m2 by three dimensional echocardiography, and 22.1 ml/m2 and 11.9 ml/m2 by MRI. The greater left atrial minimum volume in the latter was at least in part a result of breath holding. Dynamic changes in left atrial volume during the heart cycle were detectable by both methods. The higher temporal resolution of three dimensional echocardiography allowed a more precise evaluation of different phases. CONCLUSIONS—Three dimensional echocardiography and MRI were both useful methods for studying the physiological volume changes in the left atrium in children. These methods may be used for further study of the systolic and diastolic function of the heart. Keywords: three dimensional echocardiography; magnetic resonance imaging; left atrial volume; children
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- Aakhus S., Maehle J., Bjoernstad K. A new method for echocardiographic computerized three-dimensional reconstruction of left ventricular endocardial surface: in vitro accuracy and clinical repeatability of volumes. J Am Soc Echocardiogr. 1994 Nov-Dec;7(6):571–581. doi: 10.1016/s0894-7317(14)80079-5. [DOI] [PubMed] [Google Scholar]
- Acar P., Maunoury C., Antonietti T., Bonnet D., Sidi D., Kachaner J. Left ventricular ejection fraction in children measured by three-dimensional echocardiography using a new transthoracic integrated 3D-probe. A comparison with equilibrium radionuclide angiography. Eur Heart J. 1998 Oct;19(10):1583–1588. doi: 10.1053/euhj.1998.1091. [DOI] [PubMed] [Google Scholar]
- Arcilla R. A., Thilenius O. G., Chiemmongkoltip P., Ranniger K. Left atrial volume calculation by angiocardiography in children. Chest. 1973 Feb;63(2):189–197. doi: 10.1378/chest.63.2.189. [DOI] [PubMed] [Google Scholar]
- Björk L., Lodin H. Angiographic determination of left atrial and left ventricular volumes in normal children and adults. Acta Radiol Diagn (Stockh) 1965 Nov;3(6):577–580. doi: 10.1177/028418516500300612. [DOI] [PubMed] [Google Scholar]
- Bland J. M., Altman D. G. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed] [Google Scholar]
- Graham T. P., Jr, Jarmakani J. M., Canent R. V., Jr, Morrow M. N. Left heart volume estimation in infancy and childhood. Reevaluation of methodology and normal values. Circulation. 1971 Jun;43(6):895–904. doi: 10.1161/01.cir.43.6.895. [DOI] [PubMed] [Google Scholar]
- Hofstetter R., Bartz-Bazzanella P., Kentrup H., von Bernuth G. Determination of left atrial area and volume by cross-sectional echocardiography in healthy infants and children. Am J Cardiol. 1991 Oct 15;68(10):1073–1078. doi: 10.1016/0002-9149(91)90498-a. [DOI] [PubMed] [Google Scholar]
- Järvinen V. M., Kupari M. M., Poutanen V. P., Hekali P. E. Right and left atrial phasic volumetric function in mildly symptomatic dilated and hypertrophic cardiomyopathy: cine MR imaging assessment. Radiology. 1996 Feb;198(2):487–495. doi: 10.1148/radiology.198.2.8596854. [DOI] [PubMed] [Google Scholar]
- Järvinen V., Kupari M., Hekali P., Poutanen V. P. Assessment of left atrial volumes and phasic function using cine magnetic resonance imaging in normal subjects. Am J Cardiol. 1994 Jun 1;73(15):1135–1138. doi: 10.1016/0002-9149(94)90298-4. [DOI] [PubMed] [Google Scholar]
- Mohiaddin R. H., Hasegawa M. Measurement of atrial volumes by magnetic resonance imaging in healthy volunteers and in patients with myocardial infarction. Eur Heart J. 1995 Jan;16(1):106–111. doi: 10.1093/eurheartj/16.1.106. [DOI] [PubMed] [Google Scholar]
- Nosir Y. F., Fioretti P. M., Vletter W. B., Boersma E., Salustri A., Postma J. T., Reijs A. E., Ten Cate F. J., Roelandt J. R. Accurate measurement of left ventricular ejection fraction by three-dimensional echocardiography. A comparison with radionuclide angiography. Circulation. 1996 Aug 1;94(3):460–466. doi: 10.1161/01.cir.94.3.460. [DOI] [PubMed] [Google Scholar]
- Pearlman J. D., Triulzi M. O., King M. E., Abascal V. M., Newell J., Weyman A. E. Left atrial dimensions in growth and development: normal limits for two-dimensional echocardiography. J Am Coll Cardiol. 1990 Nov;16(5):1168–1174. doi: 10.1016/0735-1097(90)90549-5. [DOI] [PubMed] [Google Scholar]
- Pini R., Giannazzo G., Di Bari M., Innocenti F., Rega L., Casolo G., Devereux R. B. Transthoracic three-dimensional echocardiographic reconstruction of left and right ventricles: in vitro validation and comparison with magnetic resonance imaging. Am Heart J. 1997 Feb;133(2):221–229. doi: 10.1016/s0002-8703(97)70212-6. [DOI] [PubMed] [Google Scholar]
- Rajagopalan B., Bertram C. D., Stallard T., Lee G. D. Blood flow in pulmonary veins: III. Simultaneous measurements of their dimensions, intravascular pressure and flow. Cardiovasc Res. 1979 Dec;13(12):684–692. doi: 10.1093/cvr/13.12.684. [DOI] [PubMed] [Google Scholar]
- Roelandt J. R., Yao J., Kasprzak J. D. Three-dimensional echocardiography. Curr Opin Cardiol. 1998 Nov;13(6):386–396. doi: 10.1097/00001573-199811000-00002. [DOI] [PubMed] [Google Scholar]
- Sanfilippo A. J., Abascal V. M., Sheehan M., Oertel L. B., Harrigan P., Hughes R. A., Weyman A. E. Atrial enlargement as a consequence of atrial fibrillation. A prospective echocardiographic study. Circulation. 1990 Sep;82(3):792–797. doi: 10.1161/01.cir.82.3.792. [DOI] [PubMed] [Google Scholar]
- Schmitz L., Koch H., Bein G., Brockmeier K. Left ventricular diastolic function in infants, children, and adolescents. Reference values and analysis of morphologic and physiologic determinants of echocardiographic Doppler flow signals during growth and maturation. J Am Coll Cardiol. 1998 Nov;32(5):1441–1448. doi: 10.1016/s0735-1097(98)00379-9. [DOI] [PubMed] [Google Scholar]
- Triposkiadis F., Tentolouris K., Androulakis A., Trikas A., Toutouzas K., Kyriakidis M., Gialafos J., Toutouzas P. Left atrial mechanical function in the healthy elderly: new insights from a combined assessment of changes in atrial volume and transmitral flow velocity. J Am Soc Echocardiogr. 1995 Nov-Dec;8(6):801–809. doi: 10.1016/s0894-7317(05)80004-5. [DOI] [PubMed] [Google Scholar]
- Triposkiadis F., Wooley C. F., Boudoulas H. Mitral stenosis: left atrial dynamics reflect altered passive and active emptying. Am Heart J. 1990 Jul;120(1):124–132. doi: 10.1016/0002-8703(90)90169-x. [DOI] [PubMed] [Google Scholar]