Real-time three-dimensional echocardiography to construct clinically ready, load-independent indices of myocardial contractile performance

Combination of Real Time Three‐Dimensional Echocardiography with Diagnostic Catheterization to Derive Left Ventricular Pressure‐Volume Relations

“…After correction for body surface area, an average flow-volume loop was calculated using this method. 22 In a study by Chen et al, 23 ESPVR noninvasively measured using cuff blood pressures, electrocardiography, and two-dimensional echocardiography was shown to correlate well with invasive indices, but there was 20% variability in the slope of the single-beat relationships derived. 21 In another study that compared transthoracic 3DE with invasive sonomicrometry, ESPVR did not correlate between techniques, and this was presumed to be from inaccurate sonomicrometric modeling and the resultant overestimation of LV volume.…”

“…3DE has been previously utilized for construction of LV flow-volume loops by plotting instantaneous LV volume data sampled throughout the cardiac cycle versus their first derivative representing LV flow. 22 Although noninvasive echocardiographic means of measuring pressure-volume relations without the need for load variation have been described, they have not gained wide clinical acceptance. 20 Others have compared calibrated conductance volumes with 3DE volumes in an open-chested animal model without ESPVR derivation.…”

“…21 In another study that compared transthoracic 3DE with invasive sonomicrometry, ESPVR did not correlate between techniques, and this was presumed to be from inaccurate sonomicrometric modeling and the resultant overestimation of LV volume. 22 Although noninvasive echocardiographic means of measuring pressure-volume relations without the need for load variation have been described, they have not gained wide clinical acceptance. 22 In a study by Chen et al, 23 ESPVR noninvasively measured using cuff blood pressures, electrocardiography, and two-dimensional echocardiography was shown to correlate well with invasive indices, but there was 20% variability in the slope of the single-beat relationships derived.…”

“…22 Although noninvasive echocardiographic means of measuring pressure-volume relations without the need for load variation have been described, they have not gained wide clinical acceptance. 22 In a study by Chen et al, 23 ESPVR noninvasively measured using cuff blood pressures, electrocardiography, and two-dimensional echocardiography was shown to correlate well with invasive indices, but there was 20% variability in the slope of the single-beat relationships derived. Similarly, Gayat et al 24 in a recent study showed the feasibility of using RT3DE data (obtained over four consecutive cardiac cycles) for the LV in conjunction with carotid applana- tion tonometry to noninvasively quantify LV elastance and LV-arterial coupling.…”

Three-Dimensional Echo: Transition from Theory to Real-Time, A Technology Now Ready for Prime Time

“…55 It is interesting to note that the onset of real-time 3DE prompted investigation of newer techniques for quantifying global LV performance that rely on volume-time curves (VTCs), 59 preload recruitable stroke work, and end-systolic pressure-volume relationships. 60 Generation of these parameters by 3DE may allow a more detailed quantitative analysis of LV function and may have particular utility in the analysis of diastolic dysfunction where filling rates may be quantified. 53,59 Regardless of the method used, it is becoming apparent that 3DE may more accurately assess cardiac volumes and function than 2DE in selected populations and will likely have clinical significance.…”