Transesophageal 3-dimensional echocardiography: In vivo determination of left ventricular mass in comparison with magnetic resonance imaging

The objective of this study was to assess the accuracy and reproducibility of transesophageal 3-dimensional echocardiography (3DE) in comparison with magnetic resonance imaging (MRT) for the in vivo calculation of left ventri cular mass (LVM). In addition, mass values obtained by M-mode echocardiogra phy were compared with those calculated by MRI. Three-dimensional reconstru ction of the left ventricle was performed from a transesophageal and transg astric transducer position with a multiplane transducer in 20 patients. Lef t ventricular mass was calculated from both transducer positions by using s lices of various thicknesses, ranging from 5 to 20 mm. Reproducibility was determined by 5 repeated measurements of mass In each of 5 randomly selecte d left ventricles. M-mode echocardiography was performed according to the m ethod described by Devereux. For MRI, multiple short-axis views with 10-mm slice thickness were acquired in inspiration hold, Correlation was high for mass determined by 3DE and MRI (for 10-mm slice thickness: r = 0.99; y = 0 .99x - 0.7 g; standard error of estimate = 8.5 g; P <.001). There was no st atistical bias, and the limits of agreement ranged from +/-16.4 g to +/-27. 2 g, depending on the slice thickness. Variability was lowest for a slice t hickness of 10 mm (SD +/- 8.2 g). The reproducibility of mass determination was excellent (mean width of the 95% CI 12.8 g), Left ventricular mass val ues calculated from the transgastric and transesophageal transducer positio n were not different from each other (mean bias 0.6 +/- 9.1 g; P = ns). M-m ode-based LVM calculations showed systematic overestimation and large measu rement variability (bias 23.7 g; 95% CI +/- 92.8 g). Compared with MRI, tra nsesophageal 3DE is an accurate and reproducible method for the determinati on of LVM and clearly superior to M-mode echocardiography.