ECHO 2013 / Quantifying the Left Heart (LV and LA) Basic and Advanced Measurements
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LA Size - Volumetric
•Prolate ellipse using linear measurements (Biplane Dimension-Length)
-4π/3 ((L/2) (D1/2) (D2/2))
-L = long-axis from 4Ch, D1 and D2 = orthogonal short-axis measurements (such as PLAX and PSAX, or 4 and 2 Ch)
LA Size – Volumetric
•Biplane Dimension-Length has been shown to underestimate LA volume as errors in each linear measurement induces errors into the calculation, as well as using non-orthogonal diameters
LA Size - Volumetric
•Prolate Ellipse using Area-Length
-8/3π ((A1) (A2) /L))
-Biplane: A1 and A2 from 4 and 2Ch, L is shortest long-axis length from 4 or 2Ch
-Single Plane: Use same area for A1 and A2, (generally 4Ch)
Biplane Area-Length
LA Size - Volumetric
•Biplane Area-Length Method is the recommended ellipsoid method by the ASE given that much previous research has used this method
LA Size - Volumetric
• Simpson’s biplane method of disks
LA Size - Volumetric
•When tracing, take care not to include pulmonary veins or left atrial appendage
•Plane of the mitral annulus should be used as the apical border
LA Size - Volumetric
LA Size - Volumetric
•Normal Indexed Volume ranges have been determined using Biplane Simpson’s method of disks or Biplane Area-Length method
LA Reference Values