Echocardiography overestimates left ventricular mass: A comparative study with magnetic resonance imaging in patients with hypertension

Objective: To compare measurement of left ventricular mass (LVM) by M-mode echocardiography and magnetic resonance imaging (MRI) in hypertensive subjects. Design: A prospective study. Subjects: Twenty-four untreated hypertensive patients [19 men and five women, aged 51 ± 2 (mean ± SEM) years, supine blood pressure 159/101 ± 3/1 mmHg]. Setting: The Blood Pressure Unit, St Georges Hospital Medical School and Magnetic Resonance Unit, Royal Brompton National Heart and Lung Hospital, London. Main outcome measures: LVM estimated both by M-mode echocardiography and by MRI. Results: Using three standard M-mode formulae, widely different values of LVM were obtained with echocardiography [American Society of Echocardiography (ASE) 319 ± 21 g, Penn 273 ± 19 g, Teichholz 191 ± 11 g]. By MRI, the LVM was 232 ± 11 g. The differences between MRI and echocardiography could not be explained in terms of the timing of measurements in the cardiac cycle. When single-slice MRI measurements at the appropriate level were applied to the ASE and Penn formulae, the LVM was again overestimated. Conclusion: Our study has shown major differences in LVM estimated using methods based on one-dimensional (echocardiography) compared with three-dimensional (MRI) data. These differences seem to be largely the result of the geometrical assumptions on which M-mode measurements are based. Our findings have important clinical implications for the assessment of the severity and response to treatment of left ventricular hypertrophy in hypertensive patients.