The preferable position for quantifying left ventricular diameter by transthoracic echocardiography.

Area of Science:

• Cardiology
• Medical Imaging
• Echocardiography

Background:

• Accurate quantification of left ventricular (LV) diameter is crucial for assessing cardiac function.
• The optimal measurement site (mitral valve tip level vs. LV mid-level) for echocardiographic LV diameter remains unclear.
• Factors influencing measurement error in echocardiographic LV diameter assessment require elucidation.

Purpose of the Study:

• To compare the accuracy of LV diameter measurements at the mitral valve tip level (MV-tip) versus the LV mid-level (LV-mid).
• To identify factors that affect measurement errors in echocardiographic LV diameter assessments.

Main Methods:

• 150 patients without myocardial infarction or local asynergy underwent echocardiography and cardiac magnetic resonance imaging (CMRI).
• Echocardiographic LV diastolic diameter (LVDD) and LV systolic diameter (LVDS) were measured at both MV-tip and LV-mid.
• LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were quantified by CMRI.

Main Results:

• LV diameter measurements were smaller at MV-tip than at LV-mid.
• LV-mid measurements showed stronger correlations with CMRI-derived LV volumes (LVDD-LVEDV: R=0.89; LVDS-LVESV: R=0.93) compared to MV-tip measurements (LVDD-LVEDV: R=0.82; LVDS-LVESV: R=0.87).
• Aortic wedging angle, Valsalva diameter, left atrial diameter, patient height, and LV mass influenced measurement error, except for LVDD at the LV-mid level.

Conclusions:

• Echocardiographic LV diameter measured at the LV-mid level correlates better with LV chamber volumes determined by CMRI.
• LV diameter measurements at the LV-mid level are not affected by other confounding factors, suggesting superior reliability.