Biplane versus short-axis measures of the left atrium and ventricle in patients with systolic dysfunction assessed by magnetic resonance.

Purpose: This study aims to investigate if the time saving biplane method can be an alternative to short-axis measurements for left atrium (LA) and left ventricle (LV) in cardiac magnetic resonance of patients with extensive LV remodeling.

Materials And Methods: In 45 patients with coronary artery disease and systolic LV dysfunction [ejection fraction (EF)<50%], LA and LV end-diastolic volume, end-systolic volume, stroke volume, and EF were measured by the biplane area length and by the short-axis volume method.

Results: No statistical differences between the biplane area length and short-axis volume were found for the LA end-systolic or the LV end-diastolic volumes. However, the biplane area length method overestimated LA stroke volume by 7.1±12.3 ml, LA EF by 6.7±8.8% (both P<.001), LV stroke volume by 6.2±12.9 ml (P=.002), and LV EF by 2.6±4.6% (P<.001). The differences in LV measurements were more evident in patients with severely distorted LV. For LA volume parameters, overall consistency between biplane area length and short-axis approach was good [all intraclass correlation coefficient (ICC)≥0.74] and for LV volume parameters, overall consistency between both approaches was excellent (all ICC≥0.93).

Conclusion: In patients with LV systolic dysfunction, the short-axis volume is superior to the biplane method and should be the first choice, when accurate determination of LA and LV EF is the main clinical indication for cardiac magnetic resonance.