PMID- 38513546
OWN - NLM
STAT- MEDLINE
DCOM- 20240408
LR  - 20240408
IS  - 1872-6232 (Electronic)
IS  - 0378-3782 (Linking)
VI  - 191
DP  - 2024 Apr
TI  - Which left atrial volume measurement should we use in the neonatal intensive 
      care?
PG  - 105985
LID - S0378-3782(24)00054-9 [pii]
LID - 10.1016/j.earlhumdev.2024.105985 [doi]
AB  - BACKGROUND: Increased left atrial volume (LAV) is a marker of cardiovascular 
      risk. Echocardiography standards to assess LAV in adults and children are the 
      biplane area-length method (AL) and method of disks (MOD). LAV in neonatology is 
      usually derived as M-mode ratio between the LA and the Aorta (LAAo). The aim of 
      this study is to determine feasibility and reliability of these methods in 
      neonatal clinical practice. METHODS: Clinically indicated echocardiograms in 
      neonatal intensive care patients were retrospectively analyzed. Feasibility was 
      determined with an image quality score describing insonation angle, 
      foreshortening and wall clarity. Reliability was determined with Bland-Altman and 
      correlation coefficient analysis of intra- and inter-observer measurements. 
      RESULTS: 104 infants ranging from 23 to 39 weeks gestation were included. The 
      feasibility of LAAo, AL and MOD was comparable (median image score 4 out of 6 
      points). Linear regression between AL and MOD was excellent (R(2) 0.99). LAAo 
      best-fit with MOD was reached with curve-linear regression (R(2) 0.28) whereby a 
      LAAo of 1.60 correlated with 1.24 ml/kg, but with a wide 95 % CI. The correlation 
      coefficient within and between observers for LAAo, biplane AL, biplane MOD and 
      monoplane MOD was 0.93 (0.87-0.96), 0.98 (0.96-0.99), 0.98 (0.96-0.99), 0.99 
      (0.97-0.99) and 0.58 (0.11-0.81), 0.75 (0.44-0.89), 0.92 (0.88-0.98), 0.96 
      (0.88-0.98) respectively. CONCLUSION: All methods were equally feasible and 
      reliable when repeated by the same observer, but LAAo reliability was poor when 
      repeated by a different observer. Biplane MOD was the most reliable and thus 
      recommended in neonatal practice. Monoplane MOD performed well and could be 
      considered as alternative but might be less accurate.
CI  - Copyright (c) 2024 The Authors. Published by Elsevier B.V. All rights reserved.
FAU - Petoello, Enrico
AU  - Petoello E
AD  - John Hunter Children's Hospital, Department of Neonatology, Newcastle, NSW, 
      Australia; Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria 
      Integrata di Verona, Verona, Italy. Electronic address: 
      enrico.petoello@gmail.com.
FAU - Kerkow, Emma
AU  - Kerkow E
AD  - John Hunter Children's Hospital, Department of Neonatology, Newcastle, NSW, 
      Australia.
FAU - Phad, Nilkant
AU  - Phad N
AD  - John Hunter Children's Hospital, Department of Neonatology, Newcastle, NSW, 
      Australia; University of Newcastle, Newcastle, NSW, Australia.
FAU - Ficial, Benjamim
AU  - Ficial B
AD  - Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Integrata di 
      Verona, Verona, Italy.
FAU - de Waal, Koert
AU  - de Waal K
AD  - John Hunter Children's Hospital, Department of Neonatology, Newcastle, NSW, 
      Australia; University of Newcastle, Newcastle, NSW, Australia.
LA  - eng
PT  - Journal Article
DEP - 20240310
PL  - Ireland
TA  - Early Hum Dev
JT  - Early human development
JID - 7708381
SB  - IM
MH  - Adult
MH  - Child
MH  - Infant, Newborn
MH  - Humans
MH  - *Echocardiography, Three-Dimensional/methods
MH  - Reproducibility of Results
MH  - Intensive Care, Neonatal
MH  - Retrospective Studies
MH  - Heart Atria/diagnostic imaging
OTO - NOTNLM
OT  - Echocardiography
OT  - Feasibility
OT  - Left atrial volume
OT  - Reliability
COIS- Declaration of competing interest The authors have no relevant financial or 
      non-financial interests to disclose.
EDAT- 2024/03/22 00:44
MHDA- 2024/04/08 06:43
CRDT- 2024/03/21 19:13
PHST- 2024/01/24 00:00 [received]
PHST- 2024/03/01 00:00 [revised]
PHST- 2024/03/03 00:00 [accepted]
PHST- 2024/04/08 06:43 [medline]
PHST- 2024/03/22 00:44 [pubmed]
PHST- 2024/03/21 19:13 [entrez]
AID - S0378-3782(24)00054-9 [pii]
AID - 10.1016/j.earlhumdev.2024.105985 [doi]
PST - ppublish
SO  - Early Hum Dev. 2024 Apr;191:105985. doi: 10.1016/j.earlhumdev.2024.105985. Epub 
      2024 Mar 10.