Three methods for evaluation of left atrial volume

To compare and contrast 3 different echocardiographic methods used to measure left atrial (LA) volume: biplane area length (AL), biplane modified Simpson (SIMP), and prolate ellipse (PE) methods.

A review of consecutive patients who presented to our outpatient echocardiography laboratory for a resting transthoracic study between April 2006 and May 2006 was performed. Echocardiograms were reexamined and LA volume measured using the AL, SIMP, and PE methods. Of 102 consecutive patients evaluated, 97 had a measure of LA volume using all 3 methods. A significant difference in the measurement of mean ± SD LA volume was noted among the 3 different methods: 37 ± 16 mL/m ² for AL, 34 ± 14 mL/m ² for SIMP, and 27 ± 12 mL/m ² for PE. The PE method yielded routinely smaller values compared with either the AL or SIMP method ( P < 0.001). Differences increased with increased LA volume. The SIMP method derived consistently smaller (<5 mL/m ² ) values than those of the AL method, consistent across the full range of LA volumes.

Significant differences exist among these 3 commonly used methods for measuring LA volume. Standardization of the measurement of LA volume is recommended.