Echocardiographic assessment of left ventricular remodeling

Are left ventricular diameters suitable tools?

Karl S. Dujardin, Maurice E Sarano, Andrea Rossi, Kent R Bailey, James B. Seward

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Objectives. We sought to analyze the value of echocardiographic left ventricular (LV) diameters in assessing LV remodeling. Background. LV diameters are easily measured and commonly used as a substitute for volumetric analysis to evaluate LV remodeling caused by ventricular overload or dysfunction. However, the impact of these measurements on outcome is disputed, suggesting that they may not adequately assess LV remodeling. Methods. M-mode echocardiographically measured LV dimensions and the derived LV ejection fraction and end-systolic wall stress were compared with LV volumes and the derived LV ejection fraction and wall stress using the biplane Simpson rule. These measurements were made prospectively and simultaneously in 463 patients (289 men, 174 women; mean [±SD] age 62 ± 15 years), including 46 normal subjects, 52 with aortic regurgitation, 253 with mitral regurgitation and 112 with LV dysfunction. Results. The correlation between diameter and volume was good at end-systole (r = 0.91, p < 0.0001) and end-diastole (r = 0.86, p < 0.0001). However, the relation was exponential, and the 95% confidence interval increased with increasing diameter. The calculated LV ejection fraction and wall stress using LV diameter and volume correlated linearly with a limited range of error (r = 0.96, SEE = 5%, p < 0.0001 and r = 0.95, SEE = 20 g/cm 2, p < 0.0001, respectively). Conclusions. For assessing LV remodeling, LV diameters measured by M-mode echocardiography allow acceptable estimation of LV ejection fraction and wall stress and correlate significantly with LV volumes but are hindered by a wide range of error for assessment of LV size, especially for enlarged ventricles, suggesting that measurement of LV volume should be the preferred method of echocardiographically assessing LV remodeling.

Original languageEnglish (US)
Pages (from-to)1534-1541
Number of pages8
JournalJournal of the American College of Cardiology
Volume30
Issue number6
DOIs
StatePublished - Nov 15 1997

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Ventricular Remodeling
Stroke Volume
Diastole
Aortic Valve Insufficiency
Systole
Mitral Valve Insufficiency
Left Ventricular Dysfunction
Echocardiography
Confidence Intervals

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Echocardiographic assessment of left ventricular remodeling : Are left ventricular diameters suitable tools? / Dujardin, Karl S.; Sarano, Maurice E; Rossi, Andrea; Bailey, Kent R; Seward, James B.

In: Journal of the American College of Cardiology, Vol. 30, No. 6, 15.11.1997, p. 1534-1541.

Research output: Contribution to journalArticle

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abstract = "Objectives. We sought to analyze the value of echocardiographic left ventricular (LV) diameters in assessing LV remodeling. Background. LV diameters are easily measured and commonly used as a substitute for volumetric analysis to evaluate LV remodeling caused by ventricular overload or dysfunction. However, the impact of these measurements on outcome is disputed, suggesting that they may not adequately assess LV remodeling. Methods. M-mode echocardiographically measured LV dimensions and the derived LV ejection fraction and end-systolic wall stress were compared with LV volumes and the derived LV ejection fraction and wall stress using the biplane Simpson rule. These measurements were made prospectively and simultaneously in 463 patients (289 men, 174 women; mean [±SD] age 62 ± 15 years), including 46 normal subjects, 52 with aortic regurgitation, 253 with mitral regurgitation and 112 with LV dysfunction. Results. The correlation between diameter and volume was good at end-systole (r = 0.91, p < 0.0001) and end-diastole (r = 0.86, p < 0.0001). However, the relation was exponential, and the 95{\%} confidence interval increased with increasing diameter. The calculated LV ejection fraction and wall stress using LV diameter and volume correlated linearly with a limited range of error (r = 0.96, SEE = 5{\%}, p < 0.0001 and r = 0.95, SEE = 20 g/cm 2, p < 0.0001, respectively). Conclusions. For assessing LV remodeling, LV diameters measured by M-mode echocardiography allow acceptable estimation of LV ejection fraction and wall stress and correlate significantly with LV volumes but are hindered by a wide range of error for assessment of LV size, especially for enlarged ventricles, suggesting that measurement of LV volume should be the preferred method of echocardiographically assessing LV remodeling.",
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T2 - Are left ventricular diameters suitable tools?

AU - Dujardin, Karl S.

AU - Sarano, Maurice E

AU - Rossi, Andrea

AU - Bailey, Kent R

AU - Seward, James B.

PY - 1997/11/15

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N2 - Objectives. We sought to analyze the value of echocardiographic left ventricular (LV) diameters in assessing LV remodeling. Background. LV diameters are easily measured and commonly used as a substitute for volumetric analysis to evaluate LV remodeling caused by ventricular overload or dysfunction. However, the impact of these measurements on outcome is disputed, suggesting that they may not adequately assess LV remodeling. Methods. M-mode echocardiographically measured LV dimensions and the derived LV ejection fraction and end-systolic wall stress were compared with LV volumes and the derived LV ejection fraction and wall stress using the biplane Simpson rule. These measurements were made prospectively and simultaneously in 463 patients (289 men, 174 women; mean [±SD] age 62 ± 15 years), including 46 normal subjects, 52 with aortic regurgitation, 253 with mitral regurgitation and 112 with LV dysfunction. Results. The correlation between diameter and volume was good at end-systole (r = 0.91, p < 0.0001) and end-diastole (r = 0.86, p < 0.0001). However, the relation was exponential, and the 95% confidence interval increased with increasing diameter. The calculated LV ejection fraction and wall stress using LV diameter and volume correlated linearly with a limited range of error (r = 0.96, SEE = 5%, p < 0.0001 and r = 0.95, SEE = 20 g/cm 2, p < 0.0001, respectively). Conclusions. For assessing LV remodeling, LV diameters measured by M-mode echocardiography allow acceptable estimation of LV ejection fraction and wall stress and correlate significantly with LV volumes but are hindered by a wide range of error for assessment of LV size, especially for enlarged ventricles, suggesting that measurement of LV volume should be the preferred method of echocardiographically assessing LV remodeling.

AB - Objectives. We sought to analyze the value of echocardiographic left ventricular (LV) diameters in assessing LV remodeling. Background. LV diameters are easily measured and commonly used as a substitute for volumetric analysis to evaluate LV remodeling caused by ventricular overload or dysfunction. However, the impact of these measurements on outcome is disputed, suggesting that they may not adequately assess LV remodeling. Methods. M-mode echocardiographically measured LV dimensions and the derived LV ejection fraction and end-systolic wall stress were compared with LV volumes and the derived LV ejection fraction and wall stress using the biplane Simpson rule. These measurements were made prospectively and simultaneously in 463 patients (289 men, 174 women; mean [±SD] age 62 ± 15 years), including 46 normal subjects, 52 with aortic regurgitation, 253 with mitral regurgitation and 112 with LV dysfunction. Results. The correlation between diameter and volume was good at end-systole (r = 0.91, p < 0.0001) and end-diastole (r = 0.86, p < 0.0001). However, the relation was exponential, and the 95% confidence interval increased with increasing diameter. The calculated LV ejection fraction and wall stress using LV diameter and volume correlated linearly with a limited range of error (r = 0.96, SEE = 5%, p < 0.0001 and r = 0.95, SEE = 20 g/cm 2, p < 0.0001, respectively). Conclusions. For assessing LV remodeling, LV diameters measured by M-mode echocardiography allow acceptable estimation of LV ejection fraction and wall stress and correlate significantly with LV volumes but are hindered by a wide range of error for assessment of LV size, especially for enlarged ventricles, suggesting that measurement of LV volume should be the preferred method of echocardiographically assessing LV remodeling.

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