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European Journal of Echocardiography 2004 5(2):102; doi:10.1016/j.euje.2003.11.001
© 2004 by European Society of Cardiology
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Copyright © 2003, The European Society of Cardiology

Letter to the Editor

Stephen J. Leslie*, James S. Spratt and David B. Northridge

Department of Cardiology, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, UK

Received 30 September 2003; .

* Corresponding author. s.j.leslie{at}ed.ac.uk

Dear Professor Roelandt,

Re: Harmonic vs fundamental echocardiography for the estimation of left ventricular mass

We read with interest the article by McGavigan et al. regarding differences between fundamental and harmonic imaging for the estimation of left ventricular mass by echocardiography.1 They reported that the use of harmonic imaging overestimated left ventricular mass compared with fundamental imaging by an average of 26%.

We have performed a similar study in group of hypertensive male patients (n = 20), however, we also measured left ventricular mass by magnetic resonance imaging, the current ‘gold standard’. In common with McGavigan et al. we found that left ventricular mass measurements were 18% higher when measured by harmonic imaging (93 [25] vs 79 [20] g/m2, mean [SD]), however, the results from magnetic resonance imaging suggested that this was due to underestimation of left ventricular mass by fundamental imaging, with a good agreement between harmonic imaging and magnetic resonance imaging (93 [25] vs 95 [25] g/m2). There was no difference in intra-observer variability between fundamental and harmonic imaging.

We therefore agree with the differences reported by McGavigan et al. but question the authors' interpretation, given that they did not use magnetic resonance imaging to verify their results. Regardless of this distinction, there is clearly an important issue in the echo determination of left ventricular mass and serial measurements in patients should be made using the same technique. There is an urgent need for new ‘normal values’ with changing echo technology.

Yours sincerely,


   References
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  1. McGavigan A.D., Dunn F.G., Goodfield N.E.R. Secondary harmonic imaging overestimates left ventricular mass compared to fundamental echocardiography. Eur J Echocardiogr (2003) 4:178–181.[Abstract/Free Full Text]

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This Article
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