Comparison of two-dimensional echocardiography methods of ventricular volume quantification to cardiovascular magnetic resonance in left ventricular volume overload

Assessment of left ventricular dilation plays an important role in the management of left ventricular volume overload lesions. Various echocardiographic methods exist, such as the 5/6 area-length and biplane Simpsons, but their agreement with cardiac magnetic resonance imaging in patients with chronic left ventricular volume overload from a young age has not been assessed. This was a retrospective review of patients with moderate or worse aortic regurgitation, mitral regurgitation, or ventricular septal defect who underwent both studies within 6 months. End-diastolic and systolic volumes and dimensions were measured by echocardiography using the 5/6 area-length, biplane Simpsons, and M-mode methods, and compared to cardiac MRI-derived volumes. The 5/6 area-length method showed the best agreement with MRI and remained consistent with increasing ventricular dilation. The biplane Simpsons and M-mode-based Teichholz method underestimated ventricular dilation and performed worse with increasing dilation. When comparing ventricular dimensions by M-mode, there was a non-linear relationship between linear dimension and MRI-derived volume. Linear dimension appeared to plateau with increasing ventricular dilation, leading to underestimation in severity of dilation. The 5/6 area-length method was superior to other echocardiographic methods of ventricular volume quantification when compared with MRI.