Comparison of left and right atrial volume by echocardiography versus cardiac magnetic resonance imaging using the area-length method

Matthew Whitlock, Anuj Garg, Jill Gelow, Timothy Jacobson, Craig Broberg

    Research output: Contribution to journalArticlepeer-review

    74 Scopus citations


    Increased atrial volumes predict adverse cardiovascular events. Accordingly, accurate measurement of atrial size has become increasingly important in clinical practice. The area-length method is commonly used to estimate the volume. Disagreements between atrial volumes using echocardiography and other imaging modalities have been found. It is unclear whether this has resulted from differences in the measurement method or discrepancies among imaging modalities. We compared the right atrial (RA) and left atrial (LA) volume estimates using the area-length method for transthoracic echocardiography and cardiovascular magnetic resonance (CMR) imaging. Patients undergoing echocardiography and CMR imaging within 1 month were identified retrospectively. For both modalities, the RA and LA long-axis dimension and area were measured using standard 2- and 4-chamber views, and the volume was calculated using the area-length method for both atria. The echocardiographic and CMR values were compared using the Bland-Altman method. A total of 85 patients and 18 controls were included in the present study. The atrial volumes estimated using the area-length method were significantly smaller when measured using echocardiography than when measured using CMR imaging (LA volume 35 ± 20 vs 49 ± 30 ml/m 2, p <0.001, and RA volume 32 ± 23 vs 43 ± 29 ml/m 2, p = 0.012). The mean difference (CMR imaging minus echocardiography) was 14 ± 14 ml/m 2 for the LA and 10 ± 16 ml/m 2 for the RA volume. Similar results were found in the healthy controls. No significant intra- or interobserver variability was found within each modality. In conclusion, echocardiography consistently underestimated the atrial volumes compared to CMR imaging using the area-length method.

    Original languageEnglish (US)
    Pages (from-to)1345-1350
    Number of pages6
    JournalAmerican Journal of Cardiology
    Issue number9
    StatePublished - Nov 1 2010

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine


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