P779Left atrial volume and function: comparison between 2D and full-volume 3D imaging

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Purpose: Left atrium (LA) is involved in cardiac remodeling in a variety of cardiac disorders, with a significant bad prognostic value. Accurate evaluation of LA dimension and function could be very useful; in this setting the role of "full-volume" three-dimensional (3D) echocardiography has to be assessed.Methods: In 79 unselected subjects, who underwent to standard echocardiography for clinical purposes, we acquired a "full-volume" image of LA. Off-line, from bidimensional (2D) images we evaluated maximal (max LAV) and minimal LA volumes (min LAV) with Simpson biplane method; from 3D image, we measured LA volumes with a semiautomated border tracing method. LA ejection fraction (LA EF) was calculated for both 2D and 3D volumes.Results: In 2 patients off-line measurements were not feasible for bad acoustic window. Mean age of the study population was 64±15 years (range 24-96); we included both subjects with preserved and severely reduced global systolic function (EF 61±13%, range 19-79). Sixteen patients presented persistent atrial fibrillation (AF). For max LAV (49±28 ml from 2D and 51±31 ml from 3D, r =0.897, p<0.0001), min LAV (27±28 ml from 2D and 28±28 from 3D, r = 0.934, p<0.0001) and LA FE (52±19% from 2D and 51±21% from 3D, r = 0.786, p<0.0001) we observed an optimal correlation between 2D and 3D measurements. In patients with AF, max LAV (75±42 ml vs 42±18 ml in patients in sinus rhythm, SR, from 2D and 80±47 vs 43±20 ml from 3D, all p<0.001) and min LAV (58±41 ml vs 19±16 ml from 2D in patients in SR and 64±40 vs 19±15 ml from 3D, all p<0.0001) were significantly higher respect to patients in SR and LA FE significantly reduced (26±14 ml vs 59±14 ml from 2D in patients in SR and 20±13 vs 58±15 ml from 3D, all p<0.0001).Conclusions: 3D full-volume imaging appears highly feasible and show a good agreement with 2D imaging in quantitative evaluation of LA volumes and function, with coherent clinical meaning; shorter time requested to acquire 3D images and to perform measures could make this technique highly promising for a future routine use to evaluate LA dimension and function.

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