Related Experiment Video
Updated: Oct 18, 2026
Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery
Published on: February 20, 2017
Echocardiography overestimates left ventricular mass in hemodialysis patients relative to magnetic resonance imaging
G A Stewart1, J Foster, M Cowan
1Renal Unit, Department of Medicine and Therapeutics, Glasgow, Scotland, United Kingdom.
Insights
Echocardiography significantly overestimates left ventricular mass in hemodialysis patients compared to MRI. This overestimation is due to geometric assumptions in echocardiography, particularly in patients with left ventricular hypertrophy.
Area of Science:
- Cardiology
- Nephrology
- Medical Imaging
Background:
- Left ventricular hypertrophy (LVH) is common in chronic renal failure patients and indicates poor prognosis.
- Accurate measurement of left ventricular mass (LV mass) is crucial for managing these patients.
- Echocardiography may overestimate LV mass in hypertension, with errors increasing with LV mass.
Purpose of the Study:
- To compare left ventricular mass (LV mass) measurements between echocardiography and magnetic resonance imaging (MRI) in hemodialysis patients.
- To assess the accuracy of echocardiography in estimating LV mass in this population.
Main Methods:
- 35 hemodialysis patients were studied within 24 hours of their last dialysis session.
- LV mass was measured using both echocardiography and MRI within a three-hour interval.
- Clinic and ambulatory blood pressure, resting echocardiogram, and blood samples were collected.
Main Results:
- Data from 32 patients were analyzed.
- Clinic blood pressure, ambulatory blood pressure monitoring, and QT dispersion correlated with LV mass, with stronger correlations for MRI.
- Echocardiography showed greater intraobserver and interobserver variability.
- The difference in LV mass (echo minus MRI) increased linearly with mean mass and chamber diameter.
Conclusions:
- Echocardiography significantly overestimates LV mass relative to MRI in patients with LVH and dilation.
- Inaccurate assumptions in echocardiography's M-mode calculations lead to errors when LV geometry is abnormal.
- These errors are amplified in dialysis patients due to high prevalence of LVH and fluid status fluctuations.
Unlabelled:
Echocardiography overestimates left ventricular mass in hemodialysis patients relative to magnetic resonance imaging.
Background:
Left ventricular hypertrophy (LVH) is a common finding and a strong adverse prognostic factor in patients with chronic renal failure. An accurate method of measuring left ventricular mass (LV mass) is therefore a prerequisite in the management of these patients. Recent evidence has suggested that echocardiography overestimates LV mass in patients with essential hypertension, and this error increases with increasing LV mass.
Methods:
We studied 35 patients on maintenance hemodialysis within 24 hours of their last dialysis. LV mass was measured by both echocardiography and magnetic resonance imaging (MRI) performed less than three hours apart. Clinic and ambulatory blood pressure (ABPM), resting echocardiogram, and blood sampling were performed at the same visit.
Results:
Thirty-two patients had results from both methods. Clinic blood pressure, ABPM, and QT dispersion all correlated with LV mass, with a stronger correlation observed for MRI values. Intraobserver and interobserver variability were significantly greater for echocardiography (although similar to other published data). Comparing the two methods, the difference in LV mass values (echo minus magnetic resonance) increased in a linear fashion with an increasing mean mass and chamber diameter.
Conclusions:
Echocardiography significantly overestimates LV mass relative to MRI in the presence of LVH and dilation. This overestimation is the result of assumptions made in the calculation of mass from echocardiography M-mode images, which are invalid when LV geometry is abnormal. This error is therefore amplified in dialysis patients, the majority of whom have LVH and in whom intravascular volume is constantly changing.
Related Concept Videos
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for diagnosing...
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion, evaluates...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy