Left Ventricular Structure and Function for Postmyocardial Infarction and Heart Failure Risk Stratification by Three-dimensional Echocardiography

Gopal, Aasha S.; Chukwu, Ebere O.; Mihalatos, Dennis; Katz, Alan S.; Mathew, Sumi; Lachmann, Justine; Toole, Rena; Schapiro, William; Reichek, Nathaniel

doi:10.1016/j.echo.2007.01.014

Cited by 17 publications

(12 citation statements)

References 36 publications

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“…Twodimensional strain echocardiography, a novel method for the assessment of regional contractility, has recently been combined with tissue Doppler echocardiography to document RV dysfunction in patients with PAH, as well as improvements after vasodilator therapy (53). Although it has been used to date in relatively limited clinical settings pertaining to PAH (primarily in patients with CTEPH), 3-dimensional echocardiography may ultimately provide functional and structure information comparable with MRI (54,55).…”

Section: Cardiovascular Mri In Pah: Strengths and Weaknessesmentioning

confidence: 98%

Role of Cardiac Magnetic Resonance Imaging in the Management of Patients With Pulmonary Arterial Hypertension

Benza

Biederman

Murali

et al. 2008

Journal of the American College of Cardiology

170

107

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Pulmonary arterial hypertension (PAH) is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation that results, over time, from extensive vascular remodeling and increased pulmonary vascular resistance. Recent advances in magnetic resonance imaging (MRI) technology have led to the development of techniques for noninvasive assessment of cardiovascular structure and function, including hemodynamic parameters in the pulmonary circulation, which are superior in their identification of right ventricular morphologic changes. These advantages make cardiac MRI an attractive modality for following up and providing prognoses in patients with PAH. In this review, we summarize recent developments in the use of MRI for the diagnosis, assessment, and ongoing monitoring of patients with PAH. Over the coming decade, it can be anticipated that continued improvements in MRI image acquisition, spatial and temporal resolution, and analytical techniques will result in improved understanding of PAH pathophysiology, diagnosis, and prognostic variables, and will supplement, and may even replace, some of the invasive procedures currently applied routinely to the evaluation of PAH.

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Section: Cardiovascular Mri In Pah: Strengths and Weaknessesmentioning

confidence: 98%

Role of Cardiac Magnetic Resonance Imaging in the Management of Patients With Pulmonary Arterial Hypertension

Benza

Biederman

Murali

et al. 2008

Journal of the American College of Cardiology

170

107

View full text Add to dashboard Cite

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“…10 Similar findings were described in another study aimed at risk stratification in patients after MI and patients with heart failure. 11 However, despite the high correlation with the CMR reference values and the high reproducibility, several studies have reported that RT3DE-derived LV volumes were significantly underestimated. 7,8,10,[12][13][14][15][16] Different possible explanations have been offered that focused mostly on intertechnique acquisition and analysis differences, but none of the studies were able to conclusively identify the main sources of error.…”

Section: Quantification Of LV Volumes and Functionmentioning

confidence: 99%

Real-Time 3-Dimensional Echocardiography

2009

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O ne of the most significant developments of the last decade in ultrasound imaging of the heart was the evolution of 3-dimensional (3D) imaging from slow and labor-intense offline reconstruction to real-time volumetric imaging. This imaging modality provides valuable clinical information that empowers echocardiographers with new levels of confidence in the diagnosis of heart disease. We have previously described the technological milestones in the development of real-time 3D echocardiographic (RT3DE) imaging and its major advantages over conventional 2-dimensional echocardiography (2DE) and reviewed the published literature that supported the use of this new methodology in clinical practice. 1 Since 2006, the growing availability of RT3DE technology, its ease of use, and its multiple attractive features have sparked significant interest in the research community, resulting in a large number of publications, most of which have endorsed RT3DE imaging for clinical use by demonstrating its unique capabilities in different scenarios. In parallel, the clinical acceptance of this new tool has broadened significantly. The most recent clinically significant addition is matrix-array transesophageal echocardiography (TEE), which provides images of unprecedented quality that aid surgeons and interventional cardiologists in planning and guiding procedures and evaluating their outcomes.The purpose of the present article is to review the most recent RT3DE literature and provide readers with an update on the latest developments and the current status of this noninvasive imaging tool. Because different potential applications of RT3DE imaging have been explored to various extents, they are described here separately, and each is discussed with an emphasis on the scientifically established facts, along with the known stumbling blocks and difficulties. Quantification of LV Volumes and FunctionA firmly established advantage of 3D imaging over crosssectional slices of the heart is the improvement in the accuracy of the evaluation of left ventricular (LV) volumes and ejection fraction (EF) by eliminating the need for geometric modeling, which is inaccurate in the presence of aneurysms, asymmetrical ventricles, or wall motion abnormalities, and the errors caused by foreshortened views even in symmetrical ventricles. The value of RT3DE imaging in this context has been demonstrated by multiple studies that compared RT3DE volume measurements with widely accepted reference techniques, including radionuclide ventriculography and cardiac magnetic resonance (CMR). [2][3][4][5][6] These studies and others have demonstrated higher levels of agreement between the RT3DE approach and the respective reference technique compared with conventional 2DE methodology. Additionally, RT3DE measurements were found to be more reproducible than 2DE 4,5,7 and, in some studies, even as reproducible as CMR. 8 Interestingly, in a recent study in patients after myocardial infarction (MI), 9 RT3DE-derived LV volumes were more accurate and more reproducible than thos...

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“…Although underestimation of volumes has been reported in comparison to cardiac MRI results [18][20], the difference is likely the consequence of different tracing algorithms between the two imaging methods, including LV trabeculae in the LV volume using MRI versus excluding them using echocardiography [33]. However, for ejection fraction calculation no significant under-or overestimation has been reported in different studies [12][18] [19].…”

Section: )mentioning

confidence: 98%

“…Changing of contours made in 2D sections out of the 3D dataset is subsequently propagated throughout the 3D dataset in such a way that correction of endocardial borders is translated to the complete LV. Although slightly more time-consuming compared to biplane Simpson's method, this approach is more accurate and reproducible because it takes advantage of all 3D information generated by RT3DE [19]. Left heart contrast administration has been used to enhance border detection in patients with poor endocardial visibility (.…”

Section: )mentioning

confidence: 99%

“…Several studies have validated real-time 3D echocardiographic (RT3DE) LV quantification using cardiac magnetic resonance imaging (CMR) as the reference standard [12][18] [19][20] [21]. Thus, transthoracic RT3DE with semiautomatic border detection is now considered the echocardiographic method of choice for the fast, reproducible, and reliable assessment of LV function, especially in patients with distorted LVs and in candidates for device therapy, e.g., implantable defibrillators, biventricular pacemakers.…”

Section: Chapter 3 · Left Ventricular and Left Atrial Functionmentioning

confidence: 99%

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