Echocardiographic Assessment of Left Ventricular Remodeling: Are Left Ventricular Diameters Suitable Tools?

Objectives. We sought to analyze the value of echocardiographic left ventricular (LV) diameters in assessing LV remodeling. Background. LV diameters are easily measured and commonly used as a substitute for volumetric analysis to evaluate LV remodeling caused by ventricular overload or dysfunction. How-ever, the impact of these measurements on outcome is disputed, suggesting that they may not adequately assess LV remodeling. Methods. M-mode echocardiographically measured LV dimen-sions and the derived LV ejection fraction and end-systolic wall stress were compared with LV volumes and the derived LV ejection fraction and wall stress using the biplane Simpson rule. These measurements were made prospectively and simultaneously in 463 patients (289 men, 174 women; mean [6SD] age 62 6 15 years), including 46 normal subjects, 52 with aortic regurgitation, 253 with mitral regurgitation and 112 with LV dysfunction. Results. The correlation between diameter and volume was good at end-systole (r 5 0.91, p < 0.0001) and end-diastole (r 5 0.86, p < 0.0001). However, the relation was exponential, and the 95 % confidence interval increased with increasing diameter. The calculated LV ejection fraction and wall stress using LV diameter and volume correlated linearly with a limited range of error (r