The Accuracy of Echocardiographic Assessment of Left Ventricular Size in Children by the 5/6 Area × Length (Bullet) Method

Abstract

INTRODUCTION: Left ventricular end-diastolic volume (LVEDV) calculation is important in decision making in children with congenital heart disease (CHD). This study examined the accuracy of LVEDV calculation by the formula: 5/6 x area x length ("bullet" method), by comparing echocardiographic (ECHO) LVEDV against cardiac magnetic resonance (CMR). METHODS: ECHO and CMR data from 72 consecutive subjects with CHD < or =10 years of age were retrospectively reviewed. Exclusion criteria included: >3 months between examinations; unavailable or poor-quality images. Subxiphoid short- and long-axis echocardiographic images were analyzed. Bullet LVEDV was compared to CMR volumes. RESULTS: Seventeen subjects (median age 5.5 years, range 1-10 years) comprised the study group. ECHO and CMR LVEDV showed an excellent correlation (r = 0.97) and a good agreement with a mean difference (limits of agreement) of -1.0 mL (-13.9 to 11.9 mL). CONCLUSIONS: Subxiphoid echocardiographic bullet method of measuring LVEDV shows a good agreement with CMR obtained LV size in young children.