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Comparison of echocardiographic and anatomic measurements of the left ventricular wall thickness
1Department of Pathology, Kobe University School of Medicine.
Insights
Echocardiography (echo) measurements of left ventricular (LV) wall thickness closely correlate with autopsy findings. Including trabeculations in echo measurements improves accuracy, especially in hypertrophic hearts.
Area of Science:
- Cardiology
- Medical Imaging
- Anatomy
Background:
- Left ventricular (LV) wall thickness measurement via echocardiography (echo) is a standard cardiologic procedure.
- Assessing the accuracy of echo measurements compared to anatomical data is crucial for clinical reliability.
- The influence of LV trabeculations on echo measurements requires further investigation.
Purpose of the Study:
- To evaluate the reliability of echocardiographic measurements of LV wall thickness.
- To compare echo-derived LV wall thickness with direct anatomical measurements from autopsy.
- To determine the impact of left ventricular trabeculations on echocardiographic accuracy.
Main Methods:
- Autopsy examination of 44 formalin-fixed hearts (18 hypertrophic, 20 dilated, 6 normal).
- B-mode echocardiography to measure interventricular septum (IVS) and LV posterior wall thickness.
- Anatomical measurement of compact zone thickness and total wall thickness, including trabeculae.
Main Results:
- Echo measurements of LV wall thickness significantly correlated with both compact zone and total wall thickness (including trabeculae).
- Echo measurements more closely matched total wall thickness in normal and hypertrophic hearts.
- Trabecular morphology varied, with larger areas in dilated hearts and greater thickness in hypertrophic hearts.
Conclusions:
- Discrepancies between echo and anatomical measurements can arise from LV trabeculations.
- Including well-developed, adjoining trabeculae in echo measurements enhances reliability.
- Improved accuracy in echocardiographic LV wall thickness assessment is achievable by accounting for trabecular structures.
Abstract:
The measurement of the left ventricular (LV) wall thickness by echocardiography (echo) is an important part of cardiologic routine. To evaluate the reliability of the LV wall thickness by echo, we compared echo measurements of LV wall thickness with anatomic measurements at autopsy, and assessed the influence of the development of LV trabeculations on these measurements. LV transverse sections at the papillary muscle level of 44 formalin-fixed hearts at autopsy were investigated: 18 with concentric hypertrophic heart diseases, 20 with dilated heart diseases, and 6 normal control hearts. B-mode echo images were obtained and echo measurements of the interventricular septum (IVS) and LV posterior wall thickness were made. Anatomic measurements of compact zone thickness and total wall thickness including trabeculae and areas of compact zone, trabeculae, and LV cavity were made. Echo measurements of LV wall thickness were significantly correlated with anatomic measurements of compact zone thickness and total wall thickness including trabeculae. Echo measurements correspond more closely to anatomic measurements of total wall thickness including trabeculae than compact zone thickness alone in normal and hypertrophic hearts (r = 0.95, r = 0.78). The trabecular area correlated with compact zone area in normal and hypertrophic hearts, but it correlated with cavity area in normal and dilated hearts. Trabecular area was greater in the dilated hearts than in the normal and hypertrophic hearts, but trabecular thickness was greater in the hypertrophic hearts than in the normal and dilated hearts. From this study we found that some discrepancies between echo and anatomic measurements were caused by the development of the trabeculations. And to make echo measurements of wall thickness more reliable, we suggest that well developed and closely adjoining trabeculae should be measured as a part of LV wall thickness.