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Accuracy of three-dimensional echocardiography with unrestricted selection of imaging planes for measurement of left ventricular volumes and ejection fraction.

Abstract：

BACKGROUND:Accurate, reproducible, noninvasive determination of left ventricular (LV) volumes and ejection fraction (EF) is important for clinical assessment, risk stratification, selection of therapy, and serial monitoring of patients with cardiovascular disease. Three-dimensional echocardiography (3DE) approaches have demonstrated significantly greater accuracy than current clinical 2DE, but the clinical utility of 3DE has been limited because of the need for substantial modifications to scanning technique (eg, all image acquisition from a single acoustic window) or cumbersome additional hardware. We describe a novel 3DE system without these limitations and its application to patients. METHODS AND RESULTS:Twenty-five patients were examined by 3DE, 2DE, and magnetic resonance imaging (MRI). The 3DE system used a magnetic scanhead tracking device, and volumes were computed with a novel deformable shell model. End-diastolic volumes and EF by MRI ranged from 96 to 375 mL and 18% to 73%, respectively. There was excellent correlation, without statistically significant differences, between MRI and 3DE for end-systolic volume (ESV) (r(2) = 0.99) and end-diastolic volume (EDV) (r(2) = 0.98), ventricular stroke volume (SV) (r(2) = 0.93), and EF (r(2) = 0.97), with standard error estimates less than 10 mL for volumes and 3% for EF. Conventional 2DE consistently underestimated volumes (EDV, P <.01; ESV, P <.01; SV, P <.05); correlations with MRI were r(2) = 0.91 for ESV, r(2) = 0.88 for EDV, r(2) = 0.62 for SV, and r(2) = 0.72 for EF. Standard error estimates ranged from 16 to 20 mL for ventricular volumes and 9% for EF. Interobserver variability was reduced 3-fold with use of 3DE. CONCLUSIONS:The novel 3DE system allows unrestricted selection and combination of acoustic windows in a single examination, improves accuracy of estimates of LV volumes and EF 3-fold compared with 2DE, and is practical for routine clinical assessment of LV size and function in patients with a wide range of cardiac pathology.

journal_name

Am Heart J

journal_title

American heart journal

authors

Hibberd MG,Chuang ML,Beaudin RA,Riley MF,Mooney MG,Fearnside JT,Manning WJ,Douglas PS

doi

10.1067/mhj.2000.108513

subject

Has Abstract

pub_date

2000-09-01 00:00:00

pages

469-75

issue

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(00)05476-4

journal_volume

140

pub_type

临床试验,杂志文章

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Accuracy of three-dimensional echocardiography with unrestricted selection of imaging planes for measurement of left ventricular volumes and ejection fraction.