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Three-dimensional Echocardiographic Analysis of left Atrial size and Volumetric Function — Clinical Implications and Comparison with Other Imaging Modalities

  • Echocardiography (T Buck, Section Editor)
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Abstract

Since a number of imaging approaches are used to measure left atrial volume, it is important to know whether values obtained by different imaging modalities or by the same imaging modality using different measurement algorithms are interchangeable. This is particularly relevant for follow-up examinations. The advent of real-time full-volume three-dimensional echocardiography allows rapid measurement of chamber volume without making geometric assumptions. Furthermore, the semiautomatic methods allow repeat measurement of volume changes during the cardiac cycle thus permitting volumetric quantification of atrial function. Although three-dimensional imaging modalities including magnetic resonance imaging and computed tomography are considered as non-invasive reference methods for cardiac chamber volume determination they are less available, more costly, more time consuming and have other specific limitations, and therefore are less suitable for atrial volume and function measurement in daily clinical practice. In this article we provide a critical review of available literature validating and comparing different non-invasive three-dimensional imaging modalities and measurement algorithms used for determination of left atrial volumes with special reference to three- dimensional echocardiography.

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References

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  1. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.

    PubMed  Google Scholar 

  2. To AC, Flamm SD, Marwick TH, Klein AL. Clinical utility of multimodality LA imaging: assessment of size, function, and structure. J Am Coll Cardiol Img. 2011;4:788–98.

    Google Scholar 

  3. Barbier P, Solomon SB, Schiller NB, Glantz SA. Left atrial relaxation and left ventricular systolic function determine left atrial reservoir function. Circulation. 1999;100:427–36.

    CAS  PubMed  Google Scholar 

  4. Rosca MM, Lancellotti PP, Popescu BAB, Piérard LAL. Left atrial function: pathophysiology, echocardiographic assessment, and clinical applications. Heart. 2011;97:1982–9.

    PubMed  Google Scholar 

  5. Toma Y, Matsuda Y, Moritani K, Ogawa H, Matsuzaki M, Kusukawa R. Left atrial filling in normal human subjects: relation between left atrial contraction and left atrial early filling. Cardiovasc Res. 1987;21:255–9.

    CAS  PubMed  Google Scholar 

  6. Payne RM, Stone HL, Engelken EJ. Atrial function during volume loading. J Appl Physiol. 1971;31:326–31.

    CAS  PubMed  Google Scholar 

  7. Anwar AM, Geleijnse ML, Soliman OI, Nemes A, ten Cate FJ. Left atrial Frank-Starling law assessed by real-time, three-dimensional echocardiographic left atrial volume changes. Heart. 2007;93:1393–7.

    PubMed Central  PubMed  Google Scholar 

  8. Jarvinen V, Kupari M, Hekali P, Poutanen VP. Assessment of left atrial volumes and phasic function using cine magnetic resonance imaging in normal subjects. Am J Cardiol. 1994;73:1135–8.

    CAS  PubMed  Google Scholar 

  9. Todaro MC, Choudhuri I, Belohlavek M, Jahangir A, Carerj S, Oreto L, et al. New echocardiographic techniques for evaluation of left atrial mechanics. Eur Heart J Cardiovasc Imaging. 2012;13:973–84.

    PubMed Central  PubMed  Google Scholar 

  10. Blume GG, McLeod CJ, Barnes ME, Seward JB, Pellikka PA, Bastiansen PM, et al. Left atrial function: physiology, assessment, and clinical implications. Eur J Echocardiogr. 2011;12:421–30.

    PubMed  Google Scholar 

  11. Hoit BD. Left atrial size and function: role in prognosis. J Am Coll Cardiol. 2014;63:493–505. Review paper discussing methods to assess LA size and function and their role in predicting cardiovascular events.

    PubMed  Google Scholar 

  12. Cameli M, Lisi M, Righini FM, Mondillo S. Novel echocardiographic techniques to assess left atrial size, anatomy and function. Cardiovasc Ultrasound. 2012;10:4.

    PubMed Central  PubMed  Google Scholar 

  13. Leung DY, Boyd A, Ng AA, Chi C, Thomas L. Echocardiographic evaluation of left atrial size and function: current understanding, pathophysiologic correlates, and prognostic implications. Am Heart J. 2008;156:1056–64.

    PubMed  Google Scholar 

  14. Abhayaratna WP, Seward JB, Appleton CP, Douglas PS, Oh JK, Tajik AJ, et al. Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol. 2006;47:2357–63.

    PubMed  Google Scholar 

  15. Tsang TS, Barnes ME, Bailey KR, Leibson CL, Montgomery SC, Takemoto Y, et al. Left atrial volume: important risk marker of incident atrial fibrillation in 1655 older men and women. Mayo Clin Proc. 2001;76:467–75.

    CAS  PubMed  Google Scholar 

  16. Patel DA, Lavie CJ, Milani RV, Ventura HO. Left atrial volume index predictive of mortality independent of left ventricular geometry in a large clinical cohort with preserved ejection fraction. Mayo Clin Proc. 2011;86:730–7.

    PubMed Central  PubMed  Google Scholar 

  17. Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J. 2012;33:2719–47.

    PubMed  Google Scholar 

  18. Müller H, Noble S, Keller PF, Sigaud P, Gentil P, Lerch R, et al. Biatrial anatomical reverse remodelling after radiofrequency catheter ablation for atrial fibrillation: evidence from real-time three-dimensional echocardiography. Europace. 2008;10:1073–8.

    PubMed  Google Scholar 

  19. Berruezo A, Tamborero D, Mont L, Benito B, Tolosana JM, Sitges M, et al. Pre-procedural predictors of atrial fibrillation recurrence after circumferential pulmonary vein ablation. Eur Heart J. 2007;28:836–41.

    PubMed  Google Scholar 

  20. Akutsu YY, Kaneko KK, Kodama YY, Suyama JJ, Li HH-L, Hamazaki YY, et al. Association between left and right atrial remodeling with atrial fibrillation recurrence after pulmonary vein catheter ablation in patients with paroxysmal atrial fibrillation: a pilot study. Circ: Cardiovasc Imaging. 2011;4:524–31.

    Google Scholar 

  21. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr. 2009;10:165–93.

    PubMed  Google Scholar 

  22. Abhayaratna WPW, Fatema KK, Barnes MEM, Seward JBJ, Gersh BJB, Bailey KRK, et al. Left atrial reservoir function as a potent marker for first atrial fibrillation or flutter in persons > or = 65 years of age. Am J Cardiol. 2008;101:1626–9.

    PubMed  Google Scholar 

  23. Fatema KK, Barnes MEM, Bailey KRK, Abhayaratna WPW, Cha SS, Seward JBJ, et al. Minimum vs. maximum left atrial volume for prediction of first atrial fibrillation or flutter in an elderly cohort: a prospective study. Eur J Echocardiogr. 2009;10:282–6.

    PubMed  Google Scholar 

  24. Caselli S, Canali E, Foschi ML, Santini D, Di Angelantonio E, Pandian NG, et al. Long-term prognostic significance of three-dimensional echocardiographic parameters of the left ventricle and left atrium. Eur J Echocardiogr. 2010;11:250–6.

    PubMed  Google Scholar 

  25. Haffajee JAJ, Lee YY, Alsheikh Ali AA, Kuvin JTJ, Pandian NGN, Patel ARA. Pre-operative left atrial mechanical function predicts risk of atrial fibrillation following cardiac surgery. J Am Coll Cardiol Img. 2011;4:833–40.

    Google Scholar 

  26. Kaminski M, Steel K, Jerosch-Herold M, Khin M, Tsang S, Hauser T, et al. Strong cardiovascular prognostic implication of quantitative left atrial contractile function assessed by cardiac magnetic resonance imaging in patients with chronic hypertension. J Cardiovasc Magn Reson. 2011;13:42.

    PubMed Central  PubMed  Google Scholar 

  27. Farzaneh-Far A, Ariyarajah V, Shenoy C, Dorval JF, Kaminski M, Curillova Z, et al. Left atrial passive emptying function during dobutamine stress MR imaging is a predictor of cardiac events in patients with suspected myocardial ischemia. J Am Coll Cardiol Img. 2011;4:378–88.

    Google Scholar 

  28. Gupta S, Matulevicius SA, Ayers CR, Berry JD, Patel PC, Markham DW, et al. Left atrial structure and function and clinical outcomes in the general population. Eur Heart J. 2013;34:278–85.

    PubMed Central  PubMed  Google Scholar 

  29. Kuhl JT, Moller JE, Kristensen TS, Kelbaek H, Kofoed KF. Left atrial function and mortality in patients with NSTEMI an MDCT study. J Am Coll Cardiol Img. 2011;4:1080–7.

    Google Scholar 

  30. Russo C, Jin Z, Homma S, Rundek T, Elkind MS, Sacco RL, et al. Left atrial minimum volume and reservoir function as correlates of left ventricular diastolic function: impact of left ventricular systolic function. Heart (British Cardiac Society). 2012;98:813–20. Study with real-time 3DE demonstrating the influence of LV diastolic function on LA phasic volumes and volumetric function.

    Google Scholar 

  31. Lonborg JT, Engstrom T, Moller JE, Ahtarovski KA, Kelbaek H, Holmvang L, et al. Left atrial volume and function in patients following ST elevation myocardial infarction and the association with clinical outcome: a cardiovascular magnetic resonance study. Eur Heart J Cardiovasc Imaging. 2013;14:118–27.

    PubMed  Google Scholar 

  32. Müller H, Burri H, Shah D, Lerch R. Evaluation of left atrial size in patients with atrial arrhythmias: comparison of standard 2D versus real time 3D echocardiography. Echocardiography. 2007;24:960–6.

    PubMed  Google Scholar 

  33. Delgado V, Vidal B, Sitges M, Tamborero D, Mont L, Berruezo A, et al. Fate of left atrial function as determined by real-time three-dimensional echocardiography study after radiofrequency catheter ablation for the treatment of atrial fibrillation. Am J Cardiol. 2008;101:1285–90.

    PubMed  Google Scholar 

  34. Marsan NA, Tops LF, Holman ER, Van de Veire NR, Zeppenfeld K, Boersma E, et al. Comparison of left atrial volumes and function by real-time three-dimensional echocardiography in patients having catheter ablation for atrial fibrillation with persistence of sinus rhythm versus recurrent atrial fibrillation three months later. Am J Cardiol. 2008;102:847–53.

    PubMed  Google Scholar 

  35. Marsan NA, Bleeker GB, Ypenburg C, Van Bommel RJ, Ghio S, Van de Veire NR, et al. Real-time three-dimensional echocardiography as a novel approach to assess left ventricular and left atrium reverse remodeling and to predict response to cardiac resynchronization therapy. Heart Rhythm. 2008;5:1257–64.

    PubMed  Google Scholar 

  36. Hage FGF, Karakus GG, Luke WDW, Suwanjutah TT, Burri MVM, Nanda NCN, et al. Effect of alcohol-induced septal ablation on left atrial volume and ejection fraction assessed by real time three-dimensional transthoracic echocardiography in patients with hypertrophic cardiomyopathy. Echocardiography. 2008;25:784–9.

    PubMed  Google Scholar 

  37. Bauer F, Shiota T, White RD, Lever HM, Qin JX, Drinko J, et al. Determinant of left atrial dilation in patients with hypertrophic cardiomyopathy: a real-time 3-dimensional echocardiographic study. J Am Soc Echocardiogr. 2004;17:968–75.

    PubMed  Google Scholar 

  38. Suh IW, Song JM, Lee EY, Kang SH, Kim MJ, Kim JJ, et al. Left atrial volume measured by real-time 3-dimensional echocardiography predicts clinical outcomes in patients with severe left ventricular dysfunction and in sinus rhythm. J Am Soc Echocardiogr. 2008;21:439–45.

    PubMed  Google Scholar 

  39. Murata M, Iwanaga S, Tamura Y, Kondo M, Kouyama K, Murata M, et al. A real-time three-dimensional echocardiographic quantitative analysis of left atrial function in left ventricular diastolic dysfunction. Am J Cardiol. 2008;102:1097–102.

    PubMed  Google Scholar 

  40. Oliveira W, Campos O, Cintra F, Matos L, Vieira ML, Rollim B, et al. Impact of continuous positive airway pressure treatment on left atrial volume and function in patients with obstructive sleep apnoea assessed by real-time three-dimensional echocardiography. Heart. 2009;95:1872–8.

    CAS  PubMed Central  PubMed  Google Scholar 

  41. De Castro S, Caselli S, Di Angelantonio E, Del Colle S, Mirabelli F, Marcantonio A, et al. Relation of left atrial maximal volume measured by real-time 3D echocardiography to demographic, clinical, and Doppler variables. Am J Cardiol. 2008;101:1347–52.

    PubMed  Google Scholar 

  42. Khankirawatana B, Khankirawatana S, Porter T. How should left atrial size be reported? Comparative assessment with use of multiple echocardiographic methods. Am Heart J. 2004;147:369–74.

    PubMed  Google Scholar 

  43. King DL, Harrison MR, King Jr DL, Gopal AS, Kwan OL, DeMaria AN. Ultrasound beam orientation during standard two-dimensional imaging: assessment by three-dimensional echocardiography. J Am Soc Echocardiogr. 1992;5:569–76.

    CAS  PubMed  Google Scholar 

  44. 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;7:571–81.

    CAS  PubMed  Google Scholar 

  45. Gopal AS, King DL, Katz J, Boxt LM, King Jr DL, Shao MY. Three-dimensional echocardiographic volume computation by polyhedral surface reconstruction: in vitro validation and comparison to magnetic resonance imaging. J Am Soc Echocardiogr. 1992;5:115–24.

    CAS  PubMed  Google Scholar 

  46. Messner A, Taylor G. ALGORITHM 550. Solid Polyhedron Measures. ACM Trans Math Softw. 1980;6:121–30.

    Google Scholar 

  47. Gerard O, Billon AC, Rouet JM, Jacob M, Fradkin M, Allouche C. Efficient model-based quantification of left ventricular function in 3-D echocardiography. IEEE Trans Med Imaging. 2002;21:1059–68.

    PubMed  Google Scholar 

  48. Cook LT, Cook PN, Lee KR, Batnitzky S, Wong BY, Fritz SL, et al. An algorithm for volume estimation based on polyhedral approximation. IEEE Trans Bio-Med Eng. 1980;27:493–500.

    CAS  Google Scholar 

  49. Keller AM, Gopal AS, King DL. Left and right atrial volume by freehand three-dimensional echocardiography: in vivo validation using magnetic resonance imaging. Eur J Echocardiogr. 2000;1:55–65.

    CAS  PubMed  Google Scholar 

  50. Poutanen T, Ikonen A, Vainio P, Jokinen E, Tikanoja T. Left atrial volume assessed by transthoracic three dimensional echocardiography and magnetic resonance imaging: dynamic changes during the heart cycle in children. Heart. 2000;83:537–42.

    CAS  PubMed Central  PubMed  Google Scholar 

  51. Rodevan O, Bjornerheim R, Ljosland M, Maehle J, Smith HJ, Ihlen H. Left atrial volumes assessed by three- and two-dimensional echocardiography compared to MRI estimates. Int J Cardiac Imaging. 1999;15:397–410.

    CAS  Google Scholar 

  52. Khankirawatana B, Khankirawatana S, Lof J, Porter TR. Left atrial volume determination by three-dimensional echocardiography reconstruction: validation and application of a simplified technique. J Am Soc Echocardiogr. 2002;15:1051–6.

    PubMed  Google Scholar 

  53. Poutanen T, Jokinen E, Sairanen H, Tikanoja T. Left atrial and left ventricular function in healthy children and young adults assessed by three dimensional echocardiography. Heart. 2003;89:544–9.

    CAS  PubMed Central  PubMed  Google Scholar 

  54. Lang RM, Badano LP, Tsang W, Adams DH, Agricola E, Buck T, et al. EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography. Eur Heart J Cardiovasc Imaging. 2012;13:1–46.

    PubMed  Google Scholar 

  55. Roelandt JRTC, Kisslo J. Three-dimensional echocardiography: lessons in overcoming time and space. In: Buck T, Franke A, Monaghan MJ, editors. Three-dimensional echocardiography. Berlin Heidelberg: Springer; 2011. p. 3–19.

    Google Scholar 

  56. Buck T. Basic principles and practical application. In: Buck T, Franke A, Monaghan MJ, editors. Three-dimensional echocardiography. Berlin Heidelberg: Springer; 2011. p. 21–53.

    Google Scholar 

  57. Rohner A, Brinkert M, Kawel N, Buechel RR, Leibundgut G, Grize L, et al. Functional assessment of the left atrium by real-time three-dimensional echocardiography using a novel dedicated analysis tool: initial validation studies in comparison with computed tomography. Eur J Echocardiogr. 2011;12:497–505.

    PubMed  Google Scholar 

  58. Bauer F, Shiota T, Qin JX, White RD. Thomas JD [Measurement of left atrial and ventricular volumes in real-time 3D echocardiography. Validation by nuclear magnetic resonance]. Arch Mal Coeur Vaiss. 2001;94:31–8.

    CAS  PubMed  Google Scholar 

  59. Kuhl HP, Franke A, Merx M, Hoffmann R, Puschmann D, Hanrath P. Rapid quantification of left ventricular function and mass using transoesophageal three-dimensional echocardiography: validation of a method that uses long-axis cutplanes. Eur J Echocardiogr. 2000;1:213–21.

    CAS  PubMed  Google Scholar 

  60. Muraru D, Badano LP, Piccoli G, Gianfagna P, Del Mestre L, Ermacora D, et al. Validation of a novel automated border-detection algorithm for rapid and accurate quantitation of left ventricular volumes based on three-dimensional echocardiography. Eur J Echocardiogr. 2010;11:359–68.

    PubMed  Google Scholar 

  61. Thavendiranathan PP, Liu SS, Verhaert DD, Calleja AA, Nitinunu AA, Van Houten TT, et al. Feasibility, accuracy, and reproducibility of real-time full-volume 3D transthoracic echocardiography to measure LV volumes and systolic function: a fully automated endocardial contouring algorithm in sinus rhythm and atrial fibrillation. J Am Coll Cardiol Img. 2012;5:239–51.

    Google Scholar 

  62. Perez de Isla LL, Balcones DVD, Fernández Golfín CC, Marcos Alberca PP, Almería CC, Rodrigo JLJ, et al. Three-dimensional-wall motion tracking: a new and faster tool for myocardial strain assessment: comparison with two-dimensional-wall motion tracking. J Am Soc Echocardiogr. 2009;22:325–30.

    PubMed  Google Scholar 

  63. Hansegard J, Urheim S, Lunde K, Malm S, Rabben SI. Semi-automated quantification of left ventricular volumes and ejection fraction by real-time three-dimensional echocardiography. Cardiovasc Ultrasound. 2009;7:18.

    PubMed Central  PubMed  Google Scholar 

  64. Yang L, Georgescu B, Zheng Y, Foran DJ, Comaniciu D. A Fast and Accurate Tracking Algorithm of Left Ventricles in 3d Echocardiography. Proc / IEEE Int Symp Biomed Imaging: From Nano to Macro. 2008;5:221–4.

    Google Scholar 

  65. Yang L, Georgescu B, Zheng Y, Wang Y, Meer P, Comaniciu D. Prediction based collaborative trackers (PCT): a robust and accurate approach toward 3D medical object tracking. IEEE Trans Med Imaging. 2011;30:1921–32.

    PubMed  Google Scholar 

  66. St John Sutton M, Plappert T. Core lab, no core lab or automated LVEF? Eur J Echocardiogr. 2007;8:239–40.

    PubMed  Google Scholar 

  67. Kleijn SA, Aly MF, Terwee CB, van Rossum AC, Kamp O. Comparison between direct volumetric and speckle tracking methodologies for left ventricular and left atrial chamber quantification by three-dimensional echocardiography. Am J Cardiol. 2011;108:1038–44.

    PubMed  Google Scholar 

  68. Nagaya M, Kawasaki M, Tanaka R, Onishi N, Sato N, Ono K, et al. Quantitative validation of left atrial structure and function by two-dimensional and three-dimensional speckle tracking echocardiography: a comparative study with three-dimensional computed tomography. J Cardiol. 2013;62:188–94. Monocenter study validating assessment of LA phasic volumes and volumetric function by real-time 3DE using 3D-WMT against CCT.

    PubMed  Google Scholar 

  69. Perez de Isla L, Feltes G, Moreno J, Martinez W, Saltijeral A, de Agustin JA, et al. Quantification of left atrial volumes using three-dimensional wall motion tracking echocardiographic technology: comparison with cardiac magnetic resonance. Eur Heart J Cardiovasc Imaging. 2014;15:793–9. Monocenter study validating assessment of LA maximal and minimal volumes by real-time 3DE using 3D-WMT against MRI.

    PubMed  Google Scholar 

  70. Takeguchi T, Nishiura M, Abe Y, Ohuchi H. T K. Practical considerations for a method of rapid cardiac function analysis based on three-dimensional speckle tracking in a three-dimensional diagnostic ultrasound system. J Med Ultrasonics. 2010;37:41–9.

    Google Scholar 

  71. Li F, Wang Q, Yao GH, Zhang PF, Ge ZM, Zhang M, et al. Impact of the number of image planes of real-time three-dimensional echocardiography on the accuracy of left atrial and ventricular volume measurements. Ultrasound Med Biol. 2008;34:40–6.

    PubMed  Google Scholar 

  72. Maddukuri PV, Vieira ML, DeCastro S, Maron MS, Kuvin JT, Patel AR, et al. What is the best approach for the assessment of left atrial size? Comparison of various unidimensional and two-dimensional parameters with three-dimensional echocardiographically determined left atrial volume. J Am Soc Echocardiogr. 2006;19:1026–32.

    PubMed  Google Scholar 

  73. Jenkins C, Bricknell K, Marwick TH. Use of real-time three-dimensional echocardiography to measure left atrial volume: comparison with other echocardiographic techniques. J Am Soc Echocardiogr. 2005;18:991–7.

    PubMed  Google Scholar 

  74. Buechel RR, Sommer G, Leibundgut G, Rohner A, Riede F, Kessel-Schaefer A, et al. Assessment of left atrial functional parameters using a novel dedicated analysis tool for real-time three-dimensional echocardiography: validation in comparison to magnetic resonance imaging. Int J Cardiovasc Imaging. 2013;29:601–8. Monocenter study validating assessment of LA phasic volumes and volumetric function by real-time 3DE using endocardial border detection against MRI and comparing two semiautomatic algorithms to each other.

    PubMed  Google Scholar 

  75. Buechel RR, Stephan FP, Sommer G, Bremerich J, Zellweger MJ, Kaufmann BA. Head-to-head comparison of two-dimensional and three-dimensional echocardiographic methods for left atrial chamber quantification with magnetic resonance imaging. J Am Soc Echocardiogr. 2013;26:428–35.

    PubMed  Google Scholar 

  76. Aune E, Baekkevar M, Roislien J, Rodevand O, Otterstad JE. Normal reference ranges for left and right atrial volume indexes and ejection fractions obtained with real-time three-dimensional echocardiography. Eur J Echocardiogr. 2009;10:738–44.

    PubMed  Google Scholar 

  77. Artang R, Migrino RQ, Harmann L, Bowers M, Woods TD. Left atrial volume measurement with automated border detection by 3-dimensional echocardiography: comparison with Magnetic Resonance Imaging. Cardiovasc Ultrasound. 2009;7:16.

    PubMed Central  PubMed  Google Scholar 

  78. Azar F, Perez de Isla L, Landaeta A, Macaya C, Zamorano J. Three-Dimensional Echocardiographic Assessment of Left Atrial Size and Function and the Normal Range of Asynchrony in Healthy Individuals. Rev Esp Cardiol (English Version). 2009;62:816–9.

    Google Scholar 

  79. Saraiva RM, Yamano T, Matsumura Y, Takasaki K, Toyono M, Agler DA, et al. Left atrial function assessed by real-time 3-dimensional echocardiography is related to right ventricular systolic pressure in chronic mitral regurgitation. Am Heart J. 2009;158:309–16.

    PubMed  Google Scholar 

  80. Müller H, Frangos C, Fleury E, Righetti A, Lerch R, Burri H. Measurement of left ventricular ejection fraction by real time 3D echocardiography in patients with severe systolic dysfunction: comparison with radionuclide angiography. Echocardiography. 2010;27:58–63.

    PubMed  Google Scholar 

  81. Soliman OI, Krenning BJ, Geleijnse ML, Nemes A, Bosch JG, van Geuns RJ, et al. Quantification of left ventricular volumes and function in patients with cardiomyopathies by real-time three-dimensional echocardiography: a head-to-head comparison between two different semiautomated endocardial border detection algorithms. J Am Soc Echocardiogr. 2007;20:1042–9.

    PubMed  Google Scholar 

  82. Soliman OI, Krenning BJ, Geleijnse ML, Nemes A, van Geuns RJ, Baks T, et al. A comparison between QLAB and TomTec full volume reconstruction for real time three-dimensional echocardiographic quantification of left ventricular volumes. Echocardiography. 2007;24:967–74.

    PubMed  Google Scholar 

  83. Jenkins C, Leano R, Chan J, Marwick TH. Reconstructed versus real-time 3-dimensional echocardiography: comparison with magnetic resonance imaging. J Am Soc Echocardiogr. 2007;20:862–8.

    PubMed  Google Scholar 

  84. Jenkins C, Moir S, Chan J, Rakhit D, Haluska B, Marwick TH. Left ventricular volume measurement with echocardiography: a comparison of left ventricular opacification, three-dimensional echocardiography, or both with magnetic resonance imaging. Eur Heart J. 2009;30:98–106.

    PubMed  Google Scholar 

  85. Jenkins C, Bricknell K, Hanekom L, Marwick TH. Reproducibility and accuracy of echocardiographic measurements of left ventricular parameters using real-time three-dimensional echocardiography. J Am Coll Cardiol. 2004;44:878–86.

    PubMed  Google Scholar 

  86. Nesser HJ, Mor-Avi V, Gorissen W, Weinert L, Steringer-Mascherbauer R, Niel J, et al. Quantification of left ventricular volumes using three-dimensional echocardiographic speckle tracking: comparison with MRI. Eur Heart J. 2009;30:1565–73.

    PubMed  Google Scholar 

  87. Mor-Avi V, Yodwut C, Jenkins C, Kuhl H, Nesser HJ, Marwick TH, et al. Real-time 3D echocardiographic quantification of left atrial volume: multicenter study for validation with CMR. J Am Coll Cardiol Img. 2012;5:769–77. Multicenter study validating assessment of LA maximal and minimal volumes by real-time 3DE using endocardial border detection against MRI.

    Google Scholar 

  88. Iwataki M, Takeuchi M, Otani K, Kuwaki H, Haruki N, Yoshitani H, et al. Measurement of left atrial volume from transthoracic three-dimensional echocardiographic datasets using the biplane Simpson's technique. J Am Soc Echocardiogr. 2012;25:1319–26.

    PubMed  Google Scholar 

  89. Kataoka A, Funabashi N, Takahashi A, Yajima R, Takahashi M, Uehara M, et al. Quantitative evaluation of left atrial volumes and ejection fraction by 320-slice computed-tomography in comparison with three- and two-dimensional echocardiography: A single-center retrospective-study in 22 subjects. Int J Cardiol. 2011;153:47–54.

    PubMed  Google Scholar 

  90. Koka AR, Gould SD, Owen AN, Halpern EJ. Left Atrial Volume: Comparison of 2DÂ and 3D Transthoracic Echocardiography with ECG-gated CT Angiography. Acad Radiol. 2012;19:62–8.

    PubMed  Google Scholar 

  91. Miyasaka Y, Tsujimoto S, Maeba H, Yuasa F, Takehana K, Dote K, et al. Left atrial volume by real-time three-dimensional echocardiography: validation by 64-slice multidetector computed tomography. J Am Soc Echocardiogr. 2011;24:680–6.

    PubMed  Google Scholar 

  92. Müller H, Reverdin S, Burri H, Shah D, Lerch R. Measurement of left and right atrial volume in patients undergoing ablation for atrial arrhythmias: comparison of a manual versus semiautomatic algorithm of real time 3D echocardiography. Echocardiography. 2014;31:499–507. Monocenter study comparing semiautomatic and manual endocardial border detection algorithms for real-time 3DE assessment of left and right atrial volume to each other.

    PubMed  Google Scholar 

  93. Fukuda S, Watanabe H, Daimon M, Abe Y, Hirashiki A, Hirata K, et al. Normal values of real-time 3-dimensional echocardiographic parameters in a healthy Japanese population: the JAMP-3D Study. Circ J. 2012;76:1177–81.

    PubMed  Google Scholar 

  94. Lancellotti P, Badano LP, Lang RM, Akhaladze N, Athanassopoulos GD, Barone D, et al. Normal Reference Ranges for Echocardiography: rationale, study design, and methodology (NORRE Study). Eur Heart J Cardiovasc Imaging. 2013;14:303–8.

    PubMed  Google Scholar 

  95. Hundley WG, Bluemke DAD, Finn JPD, Flamm SDS, Fogel MAM, Friedrich MGM, et al. ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. Circulation. 2010;121:2462–508.

    PubMed  Google Scholar 

  96. Grothues FF, Smith GCG, Moon JCJCC, Bellenger NGN, Collins PP, Klein HUH, et al. Comparison of interstudy reproducibility of cardiovascular magnetic resonance with two-dimensional echocardiography in normal subjects and in patients with heart failure or left ventricular hypertrophy. Am J Cardiol. 2002;90:29–34.

    PubMed  Google Scholar 

  97. Childs HH, Ma LL, Ma MM, Clarke JJ, Cocker MM, Green JJ, et al. Comparison of long and short axis quantification of left ventricular volume parameters by cardiovascular magnetic resonance, with ex-vivo validation. J Cardiovasc Magn Reson. 2011;13:40.

    PubMed Central  PubMed  Google Scholar 

  98. Rehr RB, Malloy CR, Filipchuk NG, Peshock RM. Left ventricular volumes measured by MR imaging. Radiology. 1985;156:717–9.

    CAS  PubMed  Google Scholar 

  99. Maceira AM, Cosin-Sales J, Roughton M, Prasad SK, Pennell DJ. Reference left atrial dimensions and volumes by steady state free precession cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2010;12:65.

    PubMed Central  PubMed  Google Scholar 

  100. Jarvinen VM, Kupari MM, Hekali PE, Poutanen VP. Right atrial MR imaging studies of cadaveric atrial casts and comparison with right and left atrial volumes and function in healthy subjects. Radiology. 1994;191:137–42.

    CAS  PubMed  Google Scholar 

  101. Kuhl JT, Lonborg J, Fuchs A, Andersen MJ, Vejlstrup N, Kelbaek H, et al. Assessment of left atrial volume and function: a comparative study between echocardiography, magnetic resonance imaging and multi slice computed tomography. Int J Cardiovasc Imaging. 2012;28:1061–71.

    PubMed  Google Scholar 

  102. Wen ZZ, Zhang ZZ, Yu WW, Fan ZZ, Du JJ, Lv BB. Assessing the left atrial phasic volume and function with dual-source CT: comparison with 3 T MRI. Int J Cardiovasc Imaging. 2010;26 Suppl 1:83–92.

    PubMed  Google Scholar 

  103. Nacif MS, Barranhas AD, Turkbey E, Marchiori E, Kawel N, Mello RA, et al. Left atrial volume quantification using cardiac MRI in atrial fibrillation: comparison of the Simpson's method with biplane area-length, ellipse, and three-dimensional methods. Diagn and Interv Radiol (Ankara, Turkey). 2013;19:213–20.

    Google Scholar 

  104. Budoff MJM, Cohen MCM, Garcia MJM, Hodgson JMJ, Hundley WGJ, Lima JAJAC, et al. ACCF/AHA clinical competence statement on cardiac imaging with computed tomography and magnetic resonance. Circulation. 2005;112:598–617.

    PubMed  Google Scholar 

  105. Vandenberg BF, Weiss RM, Kinzey J, Acker M, Stark CA, Stanford W, et al. Comparison of left atrial volume by two-dimensional echocardiography and cine-computed tomography. Am J Cardiol. 1995;75:754–7.

    CAS  PubMed  Google Scholar 

  106. Messika-Zeitoun D, Bellamy M, Avierinos JF, Breen J, Eusemann C, Rossi A, et al. Left atrial remodelling in mitral regurgitation–methodologic approach, physiological determinants, and outcome implications: a prospective quantitative Doppler-echocardiographic and electron beam-computed tomographic study. Eur Heart J. 2007;28:1773–81.

    PubMed  Google Scholar 

  107. Avelar E, Durst R, Rosito GA, Thangaroopan M, Kumar S, Tournoux F, et al. Comparison of the accuracy of multidetector computed tomography versus two-dimensional echocardiography to measure left atrial volume. Am J Cardiol. 2010;106:104–9.

    PubMed  Google Scholar 

  108. Christiaens LL, Lequeux BB, Ardilouze PP, Ragot SS, Mergy JJ, Herpin DD, et al. A new method for measurement of left atrial volumes using 64-slice spiral computed tomography: comparison with two-dimensional echocardiographic techniques. Int J Cardiol. 2009;131:217–24.

    PubMed  Google Scholar 

  109. Koka AR, Yau J, Van Why C, Cohen IS, Halpern EJ. Underestimation of left atrial size measured with transthoracic echocardiography compared with 3D MDCT. Am J Roentgenol. 2010;194:W375–381.

    Google Scholar 

  110. Bastarrika G, Zudaire B, Ferreira M, Arraiza M, Saiz-Mendiguren R, Rabago G. Assessment of left atrial volumes and function in orthotopic heart transplant recipients by dual-source CT: comparison with MRI. Investig Radiol. 2010;45:72–6.

    Google Scholar 

  111. Kühl JTJ, Kofoed KFK, Møller JEJ, Hammer Hansen SS, Kristensen TT, Køber LL, et al. Assessment of left atrial volume and mechanical function in ischemic heart disease: a multi slice computed tomography study. Int J Cardiol. 2010;145:197–202.

    PubMed  Google Scholar 

  112. Fuchs A, Kuhl JT, Lonborg J, Engstrom T, Vejlstrup N, Kober L, et al. Automated assessment of heart chamber volumes and function in patients with previous myocardial infarction using multidetector computed tomography. J Cardiovasc Comput Tomogr. 2012;6:325–34.

    PubMed  Google Scholar 

  113. Takagi YY, Ehara SS, Okuyama TT, Shirai NN, Yamashita HH, Sugioka KK, et al. Comparison of determinations of left atrial volume by the biplane area-length and Simpson's methods using 64-slice computed tomography. J Cardiol. 2009;53:257–64.

    PubMed  Google Scholar 

  114. Kircher B, Abbott JA, Pau S, Gould RG, Himelman RB, Higgins CB, et al. Left atrial volume determination by biplane two-dimensional echocardiography: validation by cine computed tomography. Am Heart J. 1991;121:864–71.

    CAS  PubMed  Google Scholar 

  115. Mahabadi AA, Samy B, Seneviratne SK, Toepker MH, Bamberg F, Hoffmann U, et al. Quantitative assessment of left atrial volume by electrocardiographic-gated contrast-enhanced multidetector computed tomography. JCardiovasc Comput Tomogr. 2009;3:80–7.

    Google Scholar 

  116. Wolf F, Ourednicek P, Loewe C, Richter B, Gossinger HD, Gwechenberger M, et al. Evaluation of left atrial function by multidetector computed tomography before left atrial radiofrequency-catheter ablation: comparison of a manual and automated 3D volume segmentation method. Eur J Radiol. 2010;75:e141–6.

    PubMed  Google Scholar 

  117. Christiaens L, Varroud-Vial N, Ardilouze P, Ragot S, Mergy J, Bonnet B, et al. Real three-dimensional assessment of left atrial and left atrial appendage volumes by 64-slice spiral computed tomography in individuals with or without cardiovascular disease. Int J Cardiol. 2010;140:189–96.

    PubMed  Google Scholar 

  118. Lin FY, Devereux RB, Roman MJ, Meng J, Jow VM, Jacobs A, et al. Cardiac Chamber Volumes, Function, and Mass as Determined by 64-Multidetector Row Computed Tomography: Mean Values Among Healthy Adults Free of Hypertension and Obesity. J Am Coll Cardiol Img. 2008;1:782–6.

    Google Scholar 

  119. Müller H, Burri H, Gentil P, Lerch R, Shah D. Measurement of left atrial volume in patients undergoing ablation for atrial fibrillation: comparison of angiography and electro-anatomic (CARTO) mapping with real-time three-dimensional echocardiography. Europace. 2010;12:792–7.

    PubMed  Google Scholar 

  120. Müller H, Burri H, Gentil P, Lerch R, Shah D. Electro-anatomic (CARTO) mapping for measurement of left atrial volume: validation against real-time 3D echocardiography. Open Cardiovasc Imaging J. 2009;1:16–21.

    Google Scholar 

  121. Mor-Avi V, Jenkins C, Kuhl HP, Nesser HJ, Marwick T, Franke A, et al. Real-time 3-dimensional echocardiographic quantification of left ventricular volumes: multicenter study for validation with magnetic resonance imaging and investigation of sources of error. J Am Coll Cardiol Img. 2008;1:413–23.

    Google Scholar 

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Hajo Müller and René Lerch declare that they have no conflict of interest.

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Müller, H., Lerch, R. Three-dimensional Echocardiographic Analysis of left Atrial size and Volumetric Function — Clinical Implications and Comparison with Other Imaging Modalities. Curr Cardiovasc Imaging Rep 7, 9299 (2014). https://doi.org/10.1007/s12410-014-9299-4

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