Left ventricular hypertrophy (LVH), defined by the left ventricular mass index (LVMI), is highly prevalent in hemodialysis patients and a strong independent predictor of cardiovascular events. Compared to cardiac magnetic resonance imaging (CMR), echocardiography tends to overestimate the LVMI. Here, we evaluate the diagnostic performance of transthoracic echocardiography (TTE) compared to CMR regarding the assessment of LVMI in hemodialysis patients. TTR and CMR data for 95 hemodialysis patients who participated in the MiREnDa trial were analyzed. The LVMI was calculated by two-dimensional (2D) TTE-guided M-mode measurements employing the American Society of Echocardiography (ASE) and Teichholz (Th) formulas, which were compared to the reference method, CMR. LVH was present in 44% of patients based on LVMI measured by CMR. LVMI measured by echocardiography correlated moderately with CMR, ASE: r = 0.44 (0.34–0.62); Th: r = 0.44 (0.32–0.62). Compared to CMR, both echocardiographic formulas overestimated LVMI (mean ∆LVMI (ASE-CMR): 19.5 ± 19.48 g/m2, p < 0.001; mean ∆LVMI (Th-CMR): 15.9 ± 15.89 g/m2, p < 0.001). We found greater LVMI overestimation in patients with LVH using the ASE formula compared to the Th formula. Stratification of patients into CMR LVMI quartiles showed a continuous decrease in ∆LVMI with increasing CMR LVMI quartiles for the Th formula (p < 0.001) but not for the ASE formula (p = 0.772). Bland-Altman analysis showed that the Th formula had a constant bias independent of LVMI. Both methods had good discrimination ability for the detection of LVH (ROC-AUC: 0.819 (0.737–0.901) and 0.808 (0.723–0.892) for Th and ASE, respectively). The ASE and Th formulas overestimate LVMI in hemodialysis patients. However, the overestimation is less with the Th formula, particularly with increasing LVMI. The results suggest that the Th formula should be preferred for measurement of LVMI in chronic hemodialysis patients. The data was derived from the following clinical trial: NCT01691053 , registered on 19 September 2012 before enrollment of the first participant.

中文翻译：

---

与血液透析患者的心脏磁共振成像相比，超声心动图量化左心室质量。

左心室肥厚 (LVH) 由左心室质量指数 (LVMI) 定义，在血液透析患者中​​非常普遍，并且是心血管事件的强独立预测因子。与心脏磁共振成像 (CMR) 相比，超声心动图倾向于高估 LVMI。在这里，我们评估经胸超声心动图 (TTE) 与 CMR 相比在血液透析患者的 LVMI 评估方面的诊断性能。对参与 MiREnDa 试验的 95 名血液透析患者的 TTR 和 CMR 数据进行了分析。LVMI 是通过二维 (2D) TTE 引导的 M 模式测量计算的，采用美国超声心动图学会 (ASE) 和 Teichholz (Th) 公式，并将其与参考方法 CMR 进行比较。根据 CMR 测量的 LVMI，44% 的患者存在 LVH。超声心动图测量的 LVMI 与 CMR、ASE 中度相关：r = 0.44 (0.34–0.62)；Th：r = 0.44 (0.32–0.62)。与 CMR 相比，两种超声心动图公式都高估了 LVMI（平均 ΔLVMI (ASE-CMR)：19.5 ± 19.48 g/m2，p < 0.001；平均 ΔLVMI (Th-CMR)：15.9 ± 15.89 g/m2，p < 0.001） . 我们发现，与使用 Th 公式相比，使用 ASE 公式的 LVH 患者的 LVMI 更高。将患者分层为 CMR LVMI 四分位数显示，随着 Th 公式的 CMR LVMI 四分位数的增加（p < 0.001），ΔLVMI 持续下降，但对于 ASE 公式（p = 0.772）则不然。Bland-Altman 分析表明，Th 公式具有独立于 LVMI 的恒定偏差。两种方法对 LVH 的检测都有很好的区分能力（对于 Th 和 ASE，ROC-AUC 分别为 0.819（0.737-0.901）和 0.808（0.723-0.892）。ASE 和 Th 公式高估了血液透析患者的 LVMI。然而，Th 公式的高估较少，特别是随着 LVMI 的增加。结果表明，应首选 Th 公式来测量慢性血液透析患者的 LVMI。数据来自以下临床试验：NCT01691053，于 2012 年 9 月 19 日在第一位参与者入组前注册。