Limitations
Our sample size was limited by the number of patients with complete
hemodynamic data and with good quality echocardiographic images for the
measurement of RA/LA volumes. Although 2D Echo is widely available and
considered a useful tool for the measurement of the atrial dimensions
and function, it is however limited by the absence of an orthogonal
plane and reliance on geometric assumptions of atrial chambers [19].
For these reasons, 3D Echo is considered to be superior to 2D Echo
[20]. Acquisition of quality 2D echo is limited in the setting of
ventilation, obesity, pulmonary edema, and the limited ability to
position patients with cardiogenic shock. Although the echo images were
not obtained simultaneously with the hemodynamic measurements, changes
in atrial size happen over time due to atrial remodeling in the setting
of volume or pressure overload.