The Clinical Benefits of Adding a Third Dimension to Assess the Left Ventricle with Echocardiography

Abstract

Three-dimensional echocardiography is a novel imaging technique based on acquisition and display of volumetric data sets in the beating heart. This permits a comprehensive evaluation of left ventricular (LV) anatomy and function from a single acquisition and expands the diagnostic possibilities of noninvasive cardiology. It provides the possibility of quantitating geometry and function of LV without preestablished assumptions regarding cardiac chamber shape and allows an echocardiographic assessment of the LV that is less operator-dependent and therefore more reproducible. Further developments and improvements for widespread routine applications include higher spatial and temporal resolution to improve image quality, faster acquisition, processing and reconstruction, and fully automated quantitative analysis. At present, three-dimensional echocardiography complements routine 2DE in clinical practice, overcoming some of its limitations and offering additional valuable information that has led to recommending its use for routine assessment of the LV of patients in whom information about LV size and function is critical for their clinical management.

Value of three-dimensional echocardiography study of left ventricle function correlated to coronary arterial dominance in predicting the outcome of primary percutaneous coronary intervention

“…We used the cardiac cycle with the best endocardial detection for analysis. The LV can be visualized using different display modalities: volume rendering for visualizing morphology and spatial relationships among adjacent structures, surface rendering for quantitative purposes, and multislice (multiple 2D tomographic views extracted automatically from a single 3D data set) for morphological and functional analysis at different regional levels [13].…”

“…This permits a comprehensive evaluation of LV anatomy and function from a single acquisition. Moreover, it allows assessment of the geometry and function of LV without pre-established assumptions regarding cardiac chamber shape and allows an echocardiographic assessment of the LV that is less operator-dependent and therefore more reproducible [13].…”

Clinical and perioperative applications of three-dimensional echocardiography

“…Validation of echo against cardiac magnetic resonance imaging (MRI) (regarded as the gold-standard), nuclear imaging, and computed tomography (CT) has consistently shown 3D echo to be more accurate and reproducible compared to conventional 2D evaluation [10] . In a meta-analysis including 23 studies (1,638 echocardiograms), Dorosz et al [11] showed that 3D echo, as compared to cardiac MRI, systematically underestimates volumes and has wide limits of agreement; its performance, however, remains better than traditional 2D methods.…”

Left ventricular ejection fraction by real-time three-dimensional echocardiography

“…RT3DE has been extensively demonstrated to be more time-saving, reproducible and accurate than conventional 2D echocardiography [2]. One of the important factors that may have led to delayed acceptance of RT3DE in daily clinical practice may be the intervendor inconsistency of 3D quantitative parameters.…”