Abstract 14135: Impact of Increasing Left Ventricular and Left Atrial Size on Echocardiographic Measurements in Patients With Non-Ischemic Cardiomyopathy

• Published in: Circulation (New York, N.Y.) Vol. 144; no. Suppl_1
• Main Authors: Turkmani, Mustafa, Liu, Gui Ting, Wang, Tom K, Salam, Donna, Tang, Wai Hong W, Griffin, Brian P, Flamm, Scott D, Kwon, Deborah H
• Format: Journal Article
• Language: English
• Published: 16.11.2021
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.144.suppl_1.14135

Abstract only Background: Echocardiography is the primary imaging modality for assessment of patients with non-ischemic cardiomyopathy (NICM), but it is known to underestimate cardiac magnetic resonance (CMR) measurements of LV volumes. We sought to assess the impact of increasing left ventricular end-diastolic volume index (LVEDVi) and left atrial volume index (LAVi) on the accuracy of echocardiographic measurements, when compared to CMR. Methods: NICM patients undergoing CMR between 4/4/2001-12/29/2017 with echocardiography measurements that were obtained within 90 days were retrospectively recorded. Bland Altman analysis and Pearson’s correlation were performed to compare echocardiographic and CMR assessment. Multivariable logistic regression analysis was also performed to predict Echo bias > 50cc/m2 for LVEDVi. Results: Echocardiographic and CMR measurements of LVEDVi and LAVI were obtained in 390 and 400 patients, respectively. Figure 1 illustrates the Bland Altman and Pearson’s correlation of echo vs CMR measurements of LVEDVi and LAVi. While echo and CMR LVEDVi and LAVi were significantly correlated (r=0.762 and 0.605, respectively), there was significant increase in echocardiographic underestimation as the LVEDVi and LAVi as the left ventricle and left atrium increased in size. Multivariable logistic regression analysis is presented in Figure 1. There was a trend toward increased error in women (p=0.076), but age and BME were not significantly associated with increased echo underestimation. Increasing LVEDVi was the strongest predictor of echo underestimation (p<0.0001). Conclusion: Echo underestimation of LV and LA size in patients with NICM increases as the LV and LA size increases. Increased error in echocardiographic measurements may have significant clinical impact in regards to prognosis and procedural therapeutic management strategies.