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Updated: Apr 16, 2026
Echocardiographic Assessment of Cardiac Anatomy and Function in Adult Rats
Published on: December 13, 2019
The reproducibility and absolute values of echocardiographic measurements of left ventricular size and function in
Renee Margossian1, Shan Chen2, Lynn A Sleeper2
1Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
Insights
The 5/6 × area × length (5/6AL) algorithm offers the most reproducible left ventricular (LV) measurements in children with dilated cardiomyopathy. Using a three-beat average (3BA) further enhances measurement consistency.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Imaging
- Echocardiography
Background:
- Left ventricular (LV) size and function are crucial metrics in pediatric cardiology.
- Accurate LV quantification is essential for diagnosing and managing conditions like dilated cardiomyopathy.
- Current quantification algorithms vary in their reproducibility and agreement.
Purpose of the Study:
- To evaluate the impact of different measurement algorithms on LV size and function reproducibility.
- To assess the effect of beat averaging on measurement consistency.
- To determine the agreement among various algorithms in pediatric dilated cardiomyopathy.
Main Methods:
- Echocardiograms from 169 children with dilated cardiomyopathy were analyzed.
- Inter- and intrareader reproducibility of LV volumes was assessed using biplane Simpson, modified Simpson, and 5/6 × area × length (5/6AL) algorithms.
- Single-beat and three-beat average (3BA) measurements were compared; percentage error and intraclass correlation coefficients were calculated.
Main Results:
- The 5/6AL algorithm demonstrated superior single-beat interreader reproducibility compared to biplane Simpson.
- The 5/6AL algorithm also showed the highest single-beat intrareader reproducibility.
- The three-beat average (3BA) significantly improved reproducibility across most measures, especially in cases of LV dilation and systolic dysfunction.
Conclusions:
- The 5/6AL algorithm provides the most reproducible LV measurements in children with dilated cardiomyopathy.
- Employing a three-beat average (3BA) further enhances measurement reproducibility.
- Measurements obtained from different algorithms are not interchangeable, necessitating careful consideration in clinical practice.
Background:
Several quantification algorithms for measuring left ventricular (LV) size and function are used in clinical and research settings. The aims of this study were to investigate the effects of measurement algorithm and beat averaging on the reproducibility of measurements of the left ventricle and to assess the magnitude of agreement among the algorithms in children with dilated cardiomyopathy.
Methods:
Echocardiograms were obtained in 169 children from eight clinical centers. Inter- and intrareader reproducibility was assessed on measurements of LV volumes using the biplane Simpson, modified Simpson, and 5/6 × area × length (5/6AL) algorithms. Percentage error was calculated as inter- or intrareader difference/mean × 100. Single-beat measurements and the three-beat average (3BA) were compared. Intraclass correlation coefficients were calculated to assess agreement.
Results:
Single-beat interreader reproducibility was lowest (percentage error was highest) using biplane Simpson; 5/6AL and modified Simpson were similar but significantly better than biplane Simpson (P < .05). Single-beat intrareader reproducibility was highest using 5/6AL (P < .05). The 3BA improved reproducibility for almost all measures (P < .05). Reproducibility in both single-beat and 3BA values fell with greater LV dilation and systolic dysfunction (P < .05). Intraclass correlation coefficients were >0.95 across measures, although absolute volume and mass values were systematically lower for biplane Simpson compared with modified Simpson and 5/6AL.
Conclusions:
The reproducibility of LV size and functional measurements in children with dilated cardiomyopathy is highest using the 5/6AL algorithm and can be further improved by using the 3BA. However, values derived from different algorithms are not interchangeable.
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