SUMMARY A new and simplified method to determine left ventricular (LV) volumes with two-dimensional echocardiography (2-D echo) was developed using the parasternal long-axis and apical four-and twochamber views. An end-diastolic area (EDA) was derived using the longest minor axis (Dmax) from either of the three views and the major long axis (Lmax) gle-plane LV angiography were performed within 24 hours of each other. Five patients were excluded, three because of poor-quality 2-D echoes and two because of poor-quality LV angiograms. Among the remaining 25 patients (17 males and eight females, mean age 54 years, range 29-77 years), 18 had coronary artery disease (CAD), 16 with regional dyssynergy and two with normal wall motion; two patients had aortic insufficiency, one patient had mitral regurgitation, one patient had congestive cardiomyopathy, and three patients had normal heart evaluations. Echocardiographic Measurement of VolumesWide-angle, 2-D echoes were recorded using a mechanical sector scanner (Advanced Technology Laboratories Mark V) or a phased-array sector scanner (Varian V-3400). All studies were videotaped on 3/4-inch Umatic videocasette recorders equipped with a back-spacer search module, which allows frame-byframe bidirectional playback. The video frame rate of the system is approximately 60 frames/sec.All patients were studied in the left lateral recumbent position using multiple views through the left parasternal and apical windows. Three views were selected for measurements: parasternal long-axis, apical four-chamber and apical two-chamber. Several minoraxis LV dimensions at the upper, middle and lower third of the LV cavity were measured at end-systole and end-diastole, as previously described8 ( fig. 1)

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An accurate and simplified method to calculate left ventricular (LV) ejection fraction (EF0 derived from the ellipsoidal formula for LV volume calculation is described. The LV Minor axis (D) is obtained from the average of three equidistant LV diameters at end-diastole (Ded) and end-systole (Des), and the shortening fraction of D2 (% delta D2) calculated as (D2ed - D2es)/D2ed. EF is calculated as EF = [delta D2 + ([1 - delta D2] X delta L)] X 100, where delta L = the shortening fraction of the long axis. The coefficient of correlation between the EF by this method and the EF derived from measurements of LV volumes with the area-length method was 0.98, SEE = 3.57% (n = 50). No significant over- or underestimation was observed according to the regression equation Y = 0.922X + 0.82. Thus, this simplified method allows accurate LVEF calculation without the need for planimetry of LV area.

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