Volumetric Quantification of Global and Regional Left Ventricular Function From Real-Time Three-Dimensional Echocardiographic Images

Abstract

Background-Real-time 3D echocardiographic (RT3DE) data sets contain dynamic volumetric information on cardiac function. However, quantification of left ventricular (LV) function from 3D echocardiographic data is performed on cut-planes extracted from the 3D data sets and thus does not fully exploit the volumetric information. Accordingly, we developed a volumetric analysis technique aimed at quantification of global and regional LV function. Methods and Results-RT3DE images obtained in 30 patients (Philips 7500) were analyzed by use of custom software based on the level-set approach for semiautomated detection of LV endocardial surface throughout the cardiac cycle, from which global and regional LV volume (LVV)-time and wall motion (WM)-time curves were obtained. The study design included 3 protocols. In protocol 1, time curves obtained in 16 patients were compared point-by-point with MRI data (linear regression and Bland-Altman analyses). Global LVV correlated highly with MRI (rϭ0.98; yϭ0.99xϩ2.3) with minimal bias (1.4 mL) and narrow limits of agreement (Ϯ20 mL). WM correlated highly only in basal and midventricular segments (rϭ0.88; yϭ0.85xϩ0.7).In protocol 2, we tested the ability of this technique to differentiate populations with known differences in LV function by studying 9 patients with dilated cardiomyopathy and 9 normal subjects. All calculated indices of global and regional systolic and diastolic LV function were significantly different between the groups. In protocol 3, we tested the feasibility of automated detection of regional WM abnormalities in 11 patients. In each segment, abnormality was detected when regional shortening fraction was below a threshold obtained in normal subjects. The automated detection agreed with expert interpretation of 2D WM in 86% of segments. Conclusions-Volumetric

New Imaging-Based Tools for the Assessment of Ventricular Function in Ischemic Heart Diseases

“…The determination of regional LV volumes by 3D TTE shows a good correlation with CMR data. 8,9 Thorstensen et al have shown in their study that wall motion score index by 3D TTE presents a significant correlation with the extent of delayed gadolinium enhancement by CMR. 10 3D speckle-tracking echocardiography 3D speckle-tracking echocardiography represents an innovative technique used for the quantitative estimation of LV volumes and function, and regional wall motility disturbances with superior accuracy and reproducibility.…”

3D Myocardial Contrast Echocardiography

“…3D-echocardiography visualizes the whole LV, and it is superior to 2D-echocardiography in assessment of regional wall motion abnormalities (Corsi et al,2005). It also visualizes endocardial surface structure within a beating heart (Inoue et al,2006).…”

Echocardiographic evaluation of systolic heart failure

“…The recently validated RT3DE volumetric quantification of global and regional LV function 88 overcomes limitations of 2D echocardiography as it eliminates geometric assumptions, identifies the true LV apex and evaluates wall motion encompassing all planes 89 . Jenkins, et al 90 demonstrated the correlation of RT3DE to MRI with lower intra and inter observer variability, whilst comparing it to computed tomography, Sugeng, et al 91 have shown its superiority in LVEF and volume measurement.…”