REAL-TIME AUTOMATED ECHOCARDIOGRAPHIC MEASURES OF VENTRICULAR AREA AND AREA CHANGE - COMPARISON WITH RADIONUCLIDE TECHNIQUE

Echocardiography now permits tracking of the blood-endocardial border and automatic measurement of ventricular area throughout the cardiac c ycle. To determine the accuracy of this technique, we compared echocar diographic measurements of area with similar measurements made by radi onuclide technique in 19 children, ages 4-24 years (mean 13 years). Th e blood-endocardial border was tracked from the apical two-chamber vie w and radionuclide measurements were made from the left anterior obliq ue view. We measured echocardiographic end-diastolic area, end-systoli c area, and fractional area change from the average of five cardiac cy cles. The radionuclide area measurements were made from a gated blood pool study incorporating 700-1200 cardiac cycles. Results were compare d by bias analysis. The mean differences (+/- 1 S.D.) between left ven tricular area measurements were: end-diastole 1.13 +/- 2.3 cm2, end-sy stole -0.90 +/- 1.33 cm2, and fractional area change 7.4 +/- 9.3 (%). Differences between the measurements were within the limit of agreemen t (mean +/- 2 S.D.) in 55 of 57 measurements. The area measurements we re not free from bias; the mean differences of area measurements were significantly different from zero for end-diastolic area (P less-than- or-equal-to 0.05), end-systolic area (P less-than-or-equal-to 0.01), a nd fractional area change (P less-than-or-equal-to 0.002). Echocardiog raphy tended to underestimate end-diastolic area and fractional area c hange and it tended to overestimate end-systolic area. Real-time track ing of the blood-endocardial border is possible and allows accurate me asurement of ventricular area.