Quantification of left ventricular mass by echocardiography compared to cardiac magnet resonance imaging in hemodialysis patients

Cardiovascular Ultrasound

Uwe Malzahn¹  Julian Donhauser²  Fabian Hammer³  Christoph Wanner⁴  Vera Krane⁴  Sören Jendrik Grebe⁵  Dan Liu⁶ 

[1] Clinical Trial Center Würzburg, University Hospital Würzburg, Würzburg, Germany;Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany;Department of Internal Medicine B, Division of Cardiology, University Medicine, Greifswald, Germany;Department of Medicine I, University Hospital of Würzburg, Würzburg, Germany;Comprehensive Heart Failure Centre, University Hospital and University of Würzburg, Würzburg, Germany;Department of Medicine I, University Hospital of Würzburg, Würzburg, Germany;Department of Paediatrics, University Hospital of Erlangen, Loschgestraße 15, 91054, Erlangen, Germany;Division of Cardiology, University of Würzburg, Würzburg, Germany;

关键词: Teichholz formula;    ASE formula;    Echocardiography;    Left ventricular hypertrophy;    Left ventricular mass index;    Hemodialysis;   

DOI  :  10.1186/s12947-020-00217-y

来源: Springer

【 摘 要 】

BackgroundLeft ventricular hypertrophy (LVH), defined by the left ventricular mass index (LVMI), is highly prevalent in hemodialysis patients and a strong independent predictor of cardiovascular events. Compared to cardiac magnetic resonance imaging (CMR), echocardiography tends to overestimate the LVMI. Here, we evaluate the diagnostic performance of transthoracic echocardiography (TTE) compared to CMR regarding the assessment of LVMI in hemodialysis patients.MethodsTTR and CMR data for 95 hemodialysis patients who participated in the MiREnDa trial were analyzed. The LVMI was calculated by two-dimensional (2D) TTE-guided M-mode measurements employing the American Society of Echocardiography (ASE) and Teichholz (Th) formulas, which were compared to the reference method, CMR.ResultsLVH was present in 44% of patients based on LVMI measured by CMR. LVMI measured by echocardiography correlated moderately with CMR, ASE: r = 0.44 (0.34–0.62); Th: r = 0.44 (0.32–0.62). Compared to CMR, both echocardiographic formulas overestimated LVMI (mean ∆LVMI (ASE-CMR): 19.5 ± 19.48 g/m2, p < 0.001; mean ∆LVMI (Th-CMR): 15.9 ± 15.89 g/m2, p < 0.001). We found greater LVMI overestimation in patients with LVH using the ASE formula compared to the Th formula. Stratification of patients into CMR LVMI quartiles showed a continuous decrease in ∆LVMI with increasing CMR LVMI quartiles for the Th formula (p < 0.001) but not for the ASE formula (p = 0.772). Bland-Altman analysis showed that the Th formula had a constant bias independent of LVMI. Both methods had good discrimination ability for the detection of LVH (ROC-AUC: 0.819 (0.737–0.901) and 0.808 (0.723–0.892) for Th and ASE, respectively).ConclusionsThe ASE and Th formulas overestimate LVMI in hemodialysis patients. However, the overestimation is less with the Th formula, particularly with increasing LVMI. The results suggest that the Th formula should be preferred for measurement of LVMI in chronic hemodialysis patients.Trial registrationThe data was derived from the following clinical trial: NCT01691053, registered on 19 September 2012 before enrollment of the first participant.

【 授权许可】

CC BY