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Comparison of automatic boundary detection and manual tracing technique in echocardiographic determination of left
G C Zhang1, T Tsukada, S Nakatani
1Cardiology Division of Medicine, National Cardiovascular Center, Osaka, Japan.
Insights
Automatic boundary detection (ABD) accurately estimates left atrial (LA) volume and change in patients with coronary artery disease. This echocardiography method shows potential for assessing LA function, despite needing further technical refinement.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Left ventricular volume estimation using echocardiography with automatic boundary detection (ABD) is established.
- Left atrial (LA) volume measurement is clinically significant but less studied with ABD.
- Coronary artery disease patients with sinus rhythm were the focus group.
Purpose of the Study:
- To evaluate the feasibility of LA volume measurement using ABD.
- To compare ABD measurements with manual tracing using modified Simpson's method (SM).
Main Methods:
- Fifty-nine patients with coronary artery disease and sinus rhythm were studied.
- ABD involved setting a region of interest around the LA and mitral annulus from an apical four-chamber view.
- Maximal and minimal LA volumes (Vmax, Vmin) were measured using both ABD and SM.
Main Results:
- ABD demonstrated LA volume changes with distinct emptying phases.
- ABD measurements showed strong correlation with SM for Vmax (r=0.94), Vmin (r=0.91), and volume change (r=0.82).
- ABD provided accurate LA volume change estimation compared to SM.
Conclusions:
- ABD from the apical four-chamber view is a feasible method for accurate LA volume estimation.
- This technique holds potential value for assessing left atrial function.
- Further technical development is needed to overcome existing challenges.
Abstract:
Previous reports have indicated that echocardiography with automatic boundary detection (ABD) is useful for the noninvasive estimation of left ventricular volume. However, few data exist regarding the measurement of left atrial (LA) volume, which also provides pivotal information in the clinical setting. Therefore, the feasibility of LA volume measurement by ABD in comparison with the manual tracing using modified Simpson's method (SM) was evaluated. Fifty-nine patients with coronary artery-disease with sinus rhythm were examined. Using ABD, a region of interest was set around the LA border and mitral annulus from an apical four-chamber view. The maximal and minimal LA volume (Vmax and Vmin) were measured from the volume waveform. Using the SM, the maximal and minimal LA volume were measured by the manual tracing on frozen frames at the apical four-chamber view. The ABD displayed a curve of LA volume change that consisted of passive emptying, diastasis, and active emptying phases during the left ventricular diastolic period. Under these conditions, the Vmax and Vmin were 43.7 +/- 11.2 ml and 21.1 +/- 7.6 ml, respectively, yielding the volume change of 22.6 +/- 6.0 ml. By the SM, Vmax and Vmin were 43.1 +/- 9.9 ml (r = 0.94, p < 0.0001, y(ABD) = 0.91x (SM) + 3.6) and 22.0 +/- 9.0 ml (r = 0.91, p < 0.0001, y = 0.94x + 0.7), respectively, and the volume change was 22.8 +/- 6.1 ml (r = 0.82, p < 0.0001, y = 0.84x + 3.8). These results indicate that the ABD from the apical four-chamber approach could provide an accurate estimation of LA volume change, suggesting the potential value of this method in assessing LA function, although some technical difficulties need to be further overcome.