P342Assessment of left ventricular mass in hypertrophic cardiomyopathy patients by real-time 3D echocardiography in single-beat capture image; validation with cardiac MRI


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Abstract

Background: Left ventricular (LV) mass is an important prognostic factor in hypertrophic cardiomyopathy (HCM). LV mass can be easily accessed by M-mode or 2D echocardiography; however it includes assumption and might be incorrect in LV with asymmetricity. Real time three dimensional echocardiography (RT3DE) has been introduced as an accurate method to assess the LV mass and recently, RT3DE by single beat capture with online analysis program has been introduced. We validated LV mass using new RT3DE technique compared to cardiac magnetic resonance (CMR).Method: Thirty six HCM patients was consecutively enrolled and 3 patients was excluded due to poor RT3DE image. All the patients underwent CMR and RT3DE in a day. LV mass was derived from following method; LV mass calculated from ASE formula (M-mode mass), LV mass from truncated ellipsoid method by 2D echocardiography (2D mass), and LV mass from RT3DE (RT3DE mass). RT3DE image was acquired using SC2000 System. LV mass by CMR was also calculated.Results: Mean frame rate of RT3DE was 13.1±2.3 frame/second. Pearson's interclass coefficient (ICC) showed close correlation of RT3DE mass and CMR mass (r=0.92 and p< 0.0001). However, M-mode mass and 2D mass had smaller ICC when compared with CMR (r=0.50, p=0.01 and r=0.78, p<0.001) Bland-Altman analysis showed reasonable limits of agreement with small positive bias (15.1). Bias was greater in M-mode LV mass and 2D LV mass (-39.1 and 21.2)Conclusion: LV mass measured by single-beat captured RT3DE is feasible and correct method in HCM patients. Because LV shape is asymmetrical in HCM, LV mass derived from 2D or M-mode is much more incorrect than symmetrical LV. Correct assessment of LV mass using single-beat captured RT3DE will be useful in HCM patients in real clinical practice.

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