© 2004 by European Society of Cardiology
Copyright © 2004, The European Society of Cardiology
Reply
Medical Clinic I, University Hospital, Aachen, Germany
hkuehl{at}ukaachen.de
* Corresponding author. Tel.: +49-241-8089300; fax: +49-241-8082414.
We appreciate the interest of Drs. Manescal and Dubourg in our article and we are indebted for their constructive comments. In our study most of the data were collected during a time period where second harmonic imaging was not yet available at our institution. All subsequent studies were also acquired using the fundamental imaging mode to prevent errors associated with mixing of different imaging modalities. Moreover, we were aware of the fact that all echocardiographic formulas were originally validated using the fundamental imaging mode only. Thus, we strongly believe that the results of our study are valid. They have also been confirmed by others using magnetic resonance imaging (MRI) as reference standard.1,2 As a consequence, due to the well known limitations to derive left ventricular (LV) mass from one-dimensional measurements and due to the increased variability and poor repeatability of the method we believe that M-mode echocardiography should no longer be used for the determination of LV mass in individual patients in the clinical setting and in scientific studies including only a small number of patients. Nevertheless, we clearly acknowledge that in the past the method has proven useful in large epidemiological and pharmacological trials including large patient populations and experienced sonographers.3 Yet, the increasing availability of three-dimensional imaging techniques, such as three-dimensional echocardiography or MRI, will obviate the need to use less accurate and less robust imaging methods in the future for the calculation of LV mass. In fact, recent trials assessing LV mass changes after pharmacological intervention4 already used MRI as imaging modality. Apart from being more accurate, this modality also entails the advantage that a smaller number of patients needs to be evaluated to assess a significant treatment effect.5
 |
References |
|---|
 Top References |
|---|
- Stewart G.A, Foster J, Cowan M, Rooney E, McDonagh T, Dargie H.J, et al. Echocardiography overestimates left ventricular mass in hemodialysis patients relative to magnetic resonance imaging. Kidney Int (1999) 56:2248–2253.[CrossRef][Web of Science][Medline]
- Bottini P.B, Carr A.A, Prisant L.M, Flickinger F.W, Allison J.D, Gottdiener J.S. Magnetic resonance imaging compared to echocardiography to assess left ventricular mass in the hypertensive patient. Am J Hypertens (1995) 8:221–228.[CrossRef][Web of Science][Medline]
- Levy D, Garrison R.J, Savage D.D, Kannel W.B, Castelli W.P. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med (1990) 322:1561–1566.[Abstract]
- Pitt B, Reichek N, Willenbrock R, Zannad F, Phillips R.A, Roniker B, et al. Effects of eplerenone, enalapril, and eplerenone/enalapril in patients with essential hypertension and left ventricular hypertrophy: the 4E-left ventricular hypertrophy study. Circulation (2003) 108:1831–1838.
[Abstract/Free Full Text] - Bellenger N.G, Davies L.C, Francis J.M, Coats A.J, Pennell D.J. Reduction in sample size for studies of remodeling in heart failure by the use of cardiovascular magnetic resonance. J Cardiovasc Magn Reson (2000) 2:271–278.[Web of Science][Medline]
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||