A comparative study on the methods of echocardiographic measurement of left ventricular mass in normal subjects: M-mode, 2-dimensional area-length method and method using simpson's rule

Lim, Seon Hee; Kim, Seong Yong; Kim, An Na; Lim, Yong Seong; Kim, Young Kwon; Park, Seong Hoon

Abstract

BACKGROUND
Determination of left ventricular(LV) myocardial mass with echocardioraphy is feasible and validated. American society of echocardiography(ASE) issued recommendations for the quantitation of the left ventricle by M-mode and 2-dimensional echocardiography in 1978 and 1989, respectively. Although some controversies exist regarding the relative accuracy of M-mode and 2-dimensional techniques, many workers now agree that 2-dimensional methods are more accurate and can be applied to a higher percentage of patients. But sometimes the validated methods are not optimal when parasternal short axis view is difficult to obtain, when the ventricle is distorted, or when scar tissue constitutes a portion of the myocardial volume. METHODS: We measured left ventricular mass in 72 normal subjects using three different methods-ASE cube method with correction in M-mode(method A), area-length method from parasternal short axis view and apical four chamber view(method B), and the method using Simpson's rule from apical four chamber view(method C). RESULTS: 1) LV mass(index) was 161.8+/-30.3g(98.7+/-15.6g/m2) by method A, 166.2+/-32.8g(101.2+/-16.5g/m2) by method B, and 161.2+/-31.8g(98.2+/-15.5g/m2) by method C. 2) LV mass or index by method B was significantly different from that by method A(p<0.001) and from that by method C(p<0.001). However there was no significant difference in LV mass or index between by method A and C(p>0.05). 3) There was a strong correlation between LV mass or index by the method A and B(r=0.873, p<0.001), by the method B and C(r=0.923, p<0.001), and by the A and C(r=0.945, p<0.001). CONCLUSIONS: It is suggested that the method using Simpson's rule can reliably assess LV mass, although it results in smaller value that that by area-length method.