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Left Ventricular Mass in Hypertrophic Cardiomyopathy Assessed by 2D-Echocardiography: Validation with Magnetic
Maria Angela Losi1, Massimo Imbriaco2, Grazia Canciello2
1Department of Advanced Biomedical Sciences, University Federico II of Naples, Via S Pansini, I-80131, Naples, Italy. losi@unina.it.
Insights
Echocardiographic left ventricular (LV) mass (echoLVM) is a reliable measure in hypertrophic cardiomyopathy (HCM) patients, correlating well with cardiac magnetic resonance (CMR) LVM. However, the LV mass/volume ratio is higher with echoLVM than cmrLVM.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Hypertrophic cardiomyopathy (HCM) is a genetic heart disease characterized by LV hypertrophy.
- Accurate assessment of LV mass is crucial for managing HCM.
- Echocardiography is widely available, but its accuracy in estimating LV mass needs validation against gold standards like cardiac magnetic resonance (CMR).
Purpose of the Study:
- To validate echocardiographic left ventricular (LV) mass (echoLVM) against cardiac magnetic resonance imaging (CMR) derived LV mass (cmrLVM) in patients with HCM.
- To assess the reliability and correlation between echoLVM and cmrLVM.
- To compare LV volumes and mass/volume ratios derived from both imaging modalities.
Main Methods:
- Sixty-one patients with HCM were included.
- LV mass was calculated using both echocardiography (echoLVM) and CMR (cmrLVM), with trabeculae and papillary muscles excluded.
- Correlation and agreement between echoLVM and cmrLVM were assessed using statistical methods, including paired t-tests and intraclass correlation coefficients.
Main Results:
- There was no significant difference between echoLVM and cmrLVM (147 ± 61 g vs. 145 ± 66 g, p = 0.240).
- A strong correlation was observed between echoLVM and cmrLVM (r = 0.977, p < 0.0001), with high reliability (ρ = 0.987).
- LV end-diastolic volume was significantly higher by CMR than echo (137 ± 33 mL vs. 85 ± 28 mL, p < 0.0001), leading to a lower mass/volume ratio with CMR (1.1 ± 0.4 vs. 1.8 ± 0.8, p < 0.0001).
Conclusions:
- Echocardiographic LV mass (echoLVM) is a valid and reliable method for assessing LV mass in patients with HCM when compared to CMR.
- While echoLVM is comparable to cmrLVM, the LV mass/volume ratio differs significantly between the two methods, with echocardiography yielding higher ratios.
- These findings support the use of echocardiography for LV mass assessment in HCM, but highlight potential discrepancies in volumetric and relative mass calculations.
Abstract:
We aim to validate echocardiographic left ventricular (LV) mass (echoLVM) in sixty-one patients with hypertrophic cardiomyopathy (HCM), using cardiac magnetic resonance measures (cmrLVM) as gold standard. cmrLVM was calculated using LV short-axis images, from base to apex, whereas echoLVM by LV epicardial minus LV endocardial volumes in 4 and 2 chamber views, using Simpson disk summation; trabeculae and papillary muscle were excluded in both cmrLVM and echoLVM. cmrLVM and echoLVM were not different by paired t test (145 ± 66 vs 147 ± 61; p = 0.240), and their correlation was good (r = 0.977; p < 0.0001). Intraclass correlation demonstrated reliability of echoLVM with cmrLVM (ρ = 0.987; Cls = 0.978-0.992; p < 0.0001). LV end-diastolic volume was higher by CMR than that by echo (137 ± 33 vs 85 ± 28 mL, p < 0.0001), resulting in a lower mass/volume ratio (1.1 ± 0.4 vs 1.8 ± 0.8, p < 0.0001). EchoLVM may be determined in patients with HCM. However, mass/volume ratio is higher by echocardiography than that by CMR.
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