2014 Volume 30 Issue 4 Pages 474-480
Objective: The aim of this study is to assess the feasibility and reliability in measurements of left atrial volume using real-time 3D echocardiography （RT3DE） in healthy children.
Patients and Methods: A total of 52 healthy children （median age: 5.5 years, range: 0 to 14 years, 23 boys） were enrolled. The 3D volume data were acquired using the Philips iE-33 ultrasound system with the X7-2 probe. The 3D LA volume was measured with the QLAB 7.0. We also evaluated LA volume with the Modified-Simpson （MS） method and the Area Length method （AL） from an apical view obtained from 2D and 3D images. The intraobserver, interobserver, and inter-method agreements were assessed with its limit of agreement （LOA） and Bland-Altman analysis.
Results: The feasibility for 3D LA volume measurements was 95%. Mean maximum and minimum LA volume indexes （Max LAVI, Min LAVI） were 17.6 ± 3.7 mL/m2 and 5.9 ± 1.5 mL/m2, respectively. The LA ejection fraction was 66.3 ± 5.2%. There were no age dependency and no gender differences. The correlation of intra- and interobserver agreements of Max LAVI with its LOA were good （r = 0.97, LOA = -1.3± 3.0 mL/m2 and r = 0.90, LOA = 0.5 ± 5.2 mL/m2, respectively）. LA volume measured by RT3DE was well correlated to those measured by the 3D-MS and AL methods （r = 0.92, LOA = 1.0 ± 4.4 mL/m2, r = 0.90, LOA = -0.5 ± 5.4 mL/m2）, while LA measurements by the 2D-MS and AL methods were overestimated （r = 0.89, LOA = -3.3 ± 7.0 mL/m2, r = 0.87, LOA = -3.3 ± 6.6 mL/m2）.
Conclusions: The assessment of LA volume by RT3DE is feasible and robust, and to provide reference values for the LA volume in children, further studies are required.
