Discrepancies between echocardiographic measurements of left ventricular mass in a healthy adult population

Increased left ventricular (LV) mass is associated with increased cardiovas cular morbidity and mortality. LV mass is commonly estimated from echocardi ography according to the Penn or ASE (American Society of Echocardiography) conventions. No formal statistical test of agreement between these methods has been published. Therefore we compared M-mode echocardiographic LV mass estimates by the Penn and ASE methods in a normal adult population. M-mode echocardiographic tracings were obtained in 169 healthy volunteers and use d to calculate LV mass using the Penn and ASE methods. Med lan values of th e estimates were similar [Penn, 126 g (interquartile range 96-170 g); ASE, 129 g (105-164 g); P = 0.08] and were highly intercorrelated (r = 0.98, P < 0.0001). However, the Bland-Altman analysis of agreement revealed signific ant inconsistencies between Penn and ASE LV mass values. The difference bet ween Penn and ASE values was correlated significantly with heart size (P < 0.0001), such that, for small hearts, the Penn LV mass was lower than the A SE LV mass; in contrast, for large hearts, Penn estimates were greater than ASE values. In the upper 5% of the LV mass distribution, the median value for the Penn LV mass index was 132.4 g/m(2), compared with 116.5 g/m(2) for ASE values (2P = 0.017). Thus the two most common methods of echocardiogra phic estimation of LV mass differ significantly at the upper and lower ends of the heart size distribution. These results have important implications for both cardiac research and clinical evaluation.