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Fan L, Choy JS, Cai C, Teague SD, Guccione J, Lee LC, Kassab GS. Comparison of Left Ventricular Function Derived from Subject-Specific Inverse Finite Element Modeling Based on 3D ECHO and Magnetic Resonance Images. Bioengineering (Basel) 2024; 11:735. [PMID: 39061817 PMCID: PMC11273843 DOI: 10.3390/bioengineering11070735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/05/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Three-dimensional echocardiography (3D ECHO) and magnetic resonance (MR) imaging are frequently used in patients and animals to evaluate heart functions. Inverse finite element (FE) modeling is increasingly applied to MR images to quantify left ventricular (LV) function and estimate myocardial contractility and other cardiac biomarkers. It remains unclear, however, as to whether myocardial contractility derived from the inverse FE model based on 3D ECHO images is comparable to that derived from MR images. To address this issue, we developed a subject-specific inverse FE model based on 3D ECHO and MR images acquired from seven healthy swine models to investigate if there are differences in myocardial contractility and LV geometrical features derived using these two imaging modalities. We showed that end-systolic and end-diastolic volumes derived from 3D ECHO images are comparable to those derived from MR images (R2=0.805 and 0.969, respectively). As a result, ejection fraction from 3D ECHO and MR images are linearly correlated (R2=0.977) with the limit of agreement (LOA) ranging from -17.95% to 45.89%. Using an inverse FE modeling to fit pressure and volume waveforms in subject-specific LV geometry reconstructed from 3D ECHO and MR images, we found that myocardial contractility derived from these two imaging modalities are linearly correlated with an R2 value of 0.989, a gradient of 0.895, and LOA ranging from -6.11% to 36.66%. This finding supports using 3D ECHO images in image-based inverse FE modeling to estimate myocardial contractility.
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Affiliation(s)
- Lei Fan
- Joint Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI 53233, USA; (L.F.); (C.C.)
| | - Jenny S. Choy
- California Medical Innovations Institute, San Diego, CA 92121, USA;
| | - Chenghan Cai
- Joint Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI 53233, USA; (L.F.); (C.C.)
| | - Shawn D. Teague
- Department of Radiology, National Jewish Health, Denver, CO 80206, USA;
| | - Julius Guccione
- Department of Surgery, University of California at San Francisco, San Francisco, CA 94143, USA;
| | - Lik Chuan Lee
- Department of Mechanical Engineering, Michigan State University, East Lansing, MI 48824, USA;
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Three-dimensional echocardiographic assessment of left ventricular geometric changes following acute myocardial infarction. Int J Cardiovasc Imaging 2023; 39:607-620. [PMID: 36471104 PMCID: PMC9947019 DOI: 10.1007/s10554-022-02764-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/19/2022] [Indexed: 12/12/2022]
Abstract
Acute ST-segment elevation myocardial infarction (STEMI) is associated with left ventricular (LV) structural and functional consequences. We aimed to elucidate LV geometric changes following STEMI using three-dimensional (3D) echocardiography (3DE) and to assess their functional implications using two-dimensional (2D) speckle tracking echocardiography (STE). The study included 71 patients with STEMI who underwent baseline and 6-month follow-up 2D- and 3DE. Measured parameters included LV dimensions, biplane volumes, wall motion assessment, 2D LV global longitudinal strain (GLS), and 3D LV volumes, sphericity index and systolic dyssynchrony index. According to 3DE, LV geometric changes were classified as, adverse remodeling, reverse remodeling, and minimal LV volumetric changes. The occurrence of in-hospital and follow-up major adverse cardiovascular events (MACE) was assessed among the study population. The incidence of developing adverse remodeling was 25.4% while that of reverse remodeling was 36.6%. Adverse remodeling patients had significantly higher in-hospital MACE. Reverse remodeling was associated with significantly improved GLS, that was less evident in those with minimal LV geometric changes, and non-significant improvement for adverse remodeling group. LV baseline 2D GLS significantly correlated with follow-up 3D volumes among both reverse and adverse remodeling groups. Female gender and higher absolute GLS change upon follow-up were significantly associated with reverse remodeling. ROC-derived cutoff for adverse remodeling reallocated a substantial number of patients from the minimal change group to the adverse remodeling. Following acute STEMI, two-dimensional GLS was associated with and potentially predictive of changes in LV volumes as detected by three-dimensional echocardiography.
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Zhao D, Quill GM, Gilbert K, Wang VY, Houle HC, Legget ME, Ruygrok PN, Doughty RN, Pedrosa J, D'hooge J, Young AA, Nash MP. Systematic Comparison of Left Ventricular Geometry Between 3D-Echocardiography and Cardiac Magnetic Resonance Imaging. Front Cardiovasc Med 2021; 8:728205. [PMID: 34616783 PMCID: PMC8488135 DOI: 10.3389/fcvm.2021.728205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/18/2021] [Indexed: 01/25/2023] Open
Abstract
Aims: Left ventricular (LV) volumes estimated using three-dimensional echocardiography (3D-echo) have been reported to be smaller than those measured using cardiac magnetic resonance (CMR) imaging, but the underlying causes are not well-understood. We investigated differences in regional LV anatomy derived from these modalities and related subsequent findings to image characteristics. Methods and Results: Seventy participants (18 patients and 52 healthy participants) were imaged with 3D-echo and CMR (<1 h apart). Three-dimensional left ventricular models were constructed at end-diastole (ED) and end-systole (ES) from both modalities using previously validated software, enabling the fusion of CMR with 3D-echo by rigid registration. Regional differences were evaluated as mean surface distances for each of the 17 American Heart Association segments, and by comparing contours superimposed on images from each modality. In comparison to CMR-derived models, 3D-echo models underestimated LV end-diastolic volume (EDV) by -16 ± 22, -1 ± 25, and -18 ± 24 ml across three independent analysis methods. Average surface distance errors were largest in the basal-anterolateral segment (11-15 mm) and smallest in the mid-inferoseptal segment (6 mm). Larger errors were associated with signal dropout in anterior regions and the appearance of trabeculae at the lateral wall. Conclusions: Fusion of CMR and 3D-echo provides insight into the causes of volume underestimation by 3D-echo. Systematic signal dropout and differences in appearances of trabeculae lead to discrepancies in the delineation of LV geometry at anterior and lateral regions. A better understanding of error sources across modalities may improve correlation of clinical indices between 3D-echo and CMR.
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Affiliation(s)
- Debbie Zhao
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Gina M. Quill
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Kathleen Gilbert
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Vicky Y. Wang
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | | | - Malcolm E. Legget
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Peter N. Ruygrok
- Department of Medicine, University of Auckland, Auckland, New Zealand
- Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand
| | - Robert N. Doughty
- Department of Medicine, University of Auckland, Auckland, New Zealand
- Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand
| | - João Pedrosa
- Institute for Systems and Computer Engineering, Technology and Science, Porto, Portugal
| | - Jan D'hooge
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Alistair A. Young
- Department of Biomedical Engineering, King's College London, London, United Kingdom
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
| | - Martyn P. Nash
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
- Department of Engineering Science, University of Auckland, Auckland, New Zealand
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Hazekamp MG, Barron DJ, Dangel J, Homfray T, Jongbloed MRM, Voges I. Consensus document on optimal management of patients with common arterial trunk. Eur J Cardiothorac Surg 2021; 60:7-33. [PMID: 34017991 DOI: 10.1093/ejcts/ezaa423] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/18/2020] [Accepted: 09/30/2020] [Indexed: 01/12/2023] Open
Affiliation(s)
- Mark G Hazekamp
- Department of Cardiothoracic Surgery, University Hospital Leiden, Leiden, Netherlands
| | - David J Barron
- Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Canada
| | - Joanna Dangel
- Department of Perinatal Cardiology and Congenital Anomalies, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Tessa Homfray
- Department of Medical Genetics, Royal Brompton and Harefield hospitals NHS Trust, London, UK
| | - Monique R M Jongbloed
- Department of Anatomy and Embryology, Leiden University Medical Center, Leiden, Netherlands
| | - Inga Voges
- Department for Congenital Cardiology and Pediatric Cardiology, University Medical Center of Schleswig-Holstein, Kiel, Germany
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Kocaoglu M, Pednekar AS, Wang H, Alsaied T, Taylor MD, Rattan MS. Breath-hold and free-breathing quantitative assessment of biventricular volume and function using compressed SENSE: a clinical validation in children and young adults. J Cardiovasc Magn Reson 2020; 22:54. [PMID: 32713347 PMCID: PMC7384228 DOI: 10.1186/s12968-020-00642-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/29/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Although the breath-hold cine balanced steady state free precession (bSSFP) imaging is well established for assessment of biventricular volumes and function, shorter breath-hold times or no breath-holds are beneficial in children and severely ill or sedated patients. METHODS Clinical cardiovascular magnetic resonance (CMR) examinations from September 2019 to October 2019 that included breath-hold (BH) and free-breathing (FB) cine bSSFP imaging accelerated using compressed sensitivity encoding (C-SENSE) factor of 3 in addition to the clinical standard BH cine bSSFP imaging using SENSE factor of 2 were analyzed retrospectively. Patients with structurally normal hearts who could perform consistent BHs were included. Aortic flow measured by phase contrast acquisition was used as a reference for the left ventricular (LV) stroke volume. Comparative analysis was performed for evaluation of biventricular volumes and function, imaging times, quantitative image quality, and qualitative image scoring. RESULTS There were 26 patients who underwent all three cine scans during the study period (16.7 ± 6.4 years, body surface area (BSA) 1.6 ± 0.4 m2, heart rate 83 ± 7 beats/min). BH durations of 8 ± 1 s with C-SENSE = 3 were significantly shorter (p < 0.001) by 33% compared to 12 ± 1 s with SENSE = 2. Actual scan time for BH SENSE (4.9 ± 1.2 min) was comparable to that with FB C-SENSE (5.2 ± 1.5 min; p= NS). Biventricular stroke volume and ejection fraction, and LV mass computed using all three sequences were comparable. There was a small but statistically significant (p < 0.05) difference in LV end-diastolic volume (- 3.0 ± 6.8 ml) between BH SENSE and FB C-SENSE. There was a small but statistically significant (p < 0.005) difference in end-diastolic LV (- 5.0 ± 7.7 ml) and RV (- 6.0 ± 8.5 ml) volume and end-systolic LV (- 3.2 ± 4.3 ml) and RV(- 4.2 ± 6.8 ml) volumes between BH C-SENSE and FB C-SENSE. The LV stroke volumes from all three sequences had excellent correlations (r = 0.96, slope = 0.98-1.02) with aortic flow, with overestimation by 2.7 (5%) to 4.6 (8%) ml/beat. The image quality score was Excellent (16 of 26) to Good (10 of 26) with BH SENSE, Excellent (13 of 26) to Good (13 of 26) with BH C-SENSE, and Excellent (3 of 26) to Good (21 of 26) to Adequate (2 of 26) with FB C-SENSE. CONCLUSIONS Image quality and ventricular volumetric and functional indices using either BH or FB C-SENSE cine bSSFP imaging were comparable to standard BH SENSE cine bSSFP imaging while maintaining nominally identical spatio-temporal resolution. This accelerated image acquisition provides an alternative to accommodate patients with impaired BH capacity.
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Affiliation(s)
- Murat Kocaoglu
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
| | - Amol S. Pednekar
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Hui Wang
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH USA
- MR Clinical Science, Philips Healthcare, Cincinnati, OH USA
| | - Tarek Alsaied
- The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Michael D. Taylor
- The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Mantosh S. Rattan
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH USA
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Antohi EL, Chioncel O. Understanding cardiac systolic performance beyond left ventricular ejection fraction. EXPLORATION OF MEDICINE 2020. [DOI: 10.37349/emed.2020.00006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Left ventricular ejection fraction is the critical parameter used for heart failure classification, decision making and assessing prognosis. It is defined as a volumetric ratio and is essentially a composite of arterial and ventricular elastances, but not intrinsic contractility. The clinician should be aware of its numerous limitations when measuring and reporting it. And make a step toward more insightful understanding of hemodynamics.
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Affiliation(s)
- Elena-Laura Antohi
- ICCU and Cardiology 1st Department, Emergency Institute for Cardiovascular Diseases “C.C.Iliescu”, 022328 Bucharest, Romania; University for Medicine and Pharmacy “Carol Davila” Bucharest, 020021, Bucharest, Romania
| | - Ovidiu Chioncel
- ICCU and Cardiology 1st Department, Emergency Institute for Cardiovascular Diseases “C.C.Iliescu”, 022328 Bucharest, Romania
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Beitner N, Jenner J, Sörensson P. Comparison of Left Ventricular Volumes Measured by 3DE, SPECT and CMR. J Cardiovasc Imaging 2019; 27:200-211. [PMID: 31161750 PMCID: PMC6669182 DOI: 10.4250/jcvi.2019.27.e26] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 01/20/2019] [Accepted: 03/31/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Information regarding left ventricular (LV) volume and left ventricular ejection fraction (LVEF) has major diagnostic and prognostic value when assessing patients after ST-elevation myocardial infarction (STEMI). We aimed to investigate the agreement between measurement of LV volumes and LVEF by three-dimensional echocardiography (3DE), single-photon emission computed tomography (SPECT) and cardiac magnetic resonance (CMR) imaging in patients in a stable phase after STEMI. METHODS Fifteen patients underwent examinations by 3DE, SPECT and CMR three months after STEMI. RESULTS There was a significant bias in end-diastolic volume (EDV) measured by 3DE (–64 mL, p < 0.001) and SPECT (–55 mL, p < 0.001) compared with that measured by CMR. This was also the case for end-systolic volume (ESV) measured by 3DE (–36 mL, p < 0.001) and SPECT (–28 mL, p < 0.001). No significant differences were found between 3DE and SPECT for EDV or ESV. However, LVEF did not differ between the three methods. The agreement between all three methods was moderate (intra-class correlation coefficient [ICC] = 0.44) for LV volume and good for LVEF (ICC = 0.72). CONCLUSIONS LV volumes assessed by 3DE did not differ from SPECT, and despite larger LV volumes by CMR, measurements of LVEF showed good agreement between all three methods.
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Affiliation(s)
- Natalie Beitner
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Jonas Jenner
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.
| | - Peder Sörensson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
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Rodriguez‐Mañero M, Azcárate‐Agüero P, Kreidieh B, Alvez MT, Martínez‐Monzonís A, Diaz‐Dorronsoro A, Cid‐Menéndez A, González‐Juanatey JR, Barba‐Cosials J, Rábago G, Bastarrika G. Quantitative assessment of left ventricular size and function in cardiac transplant recipients: Side‐by‐side comparison of real time two‐dimensional echocardiography, contrast‐enhanced two‐dimensional echocardiography, three‐dimensional echocardiography, and contrast‐enhanced three‐dimensional echocardiography as compared to magnetic resonance imaging. Echocardiography 2019; 36:306-311. [DOI: 10.1111/echo.14232] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 11/17/2018] [Indexed: 12/30/2022] Open
Affiliation(s)
- Moises Rodriguez‐Mañero
- Servicio de CardioloxíaComplexo Hospitalario Universitario de Santiago de Compostela (CHUS) Santiago de Compostela Spain
- IDIS (Instituto para el Desarrollo e Integración de la Salud) Santiago de Compostela Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 ‐ CB16/11/00420) Madrid Spain
| | | | - Bahij Kreidieh
- JFK Medical Center Palm Beach Regional GME ConsortiumUniversity of Miami Miami Florida
| | - María Teresa Alvez
- Servicio de CardioloxíaComplexo Hospitalario Universitario de Santiago de Compostela (CHUS) Santiago de Compostela Spain
| | - Amparo Martínez‐Monzonís
- Servicio de CardioloxíaComplexo Hospitalario Universitario de Santiago de Compostela (CHUS) Santiago de Compostela Spain
- IDIS (Instituto para el Desarrollo e Integración de la Salud) Santiago de Compostela Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 ‐ CB16/11/00420) Madrid Spain
| | - Agnes Diaz‐Dorronsoro
- Servicio de Cardiología y Cirugía CardiacaClínica Universidad de Navarra Pamplona Spain
| | - Adrian Cid‐Menéndez
- Servicio de CardioloxíaComplexo Hospitalario Universitario de Santiago de Compostela (CHUS) Santiago de Compostela Spain
| | - José Ramón González‐Juanatey
- Servicio de CardioloxíaComplexo Hospitalario Universitario de Santiago de Compostela (CHUS) Santiago de Compostela Spain
- IDIS (Instituto para el Desarrollo e Integración de la Salud) Santiago de Compostela Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 ‐ CB16/11/00420) Madrid Spain
| | - Joaquin Barba‐Cosials
- Servicio de Cardiología y Cirugía CardiacaClínica Universidad de Navarra Pamplona Spain
| | - Gregorio Rábago
- Servicio de Cardiología y Cirugía CardiacaClínica Universidad de Navarra Pamplona Spain
| | - Gorka Bastarrika
- Servicio de Cardiología y Cirugía CardiacaClínica Universidad de Navarra Pamplona Spain
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Ola RK, Meena CB, Ramakrishnan S, Agarwal A, Bhargava S. Detection of Left Ventricular Remodeling in Acute ST Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention by Two Dimensional and Three Dimensional Echocardiography. J Cardiovasc Echogr 2018; 28:39-44. [PMID: 29629258 PMCID: PMC5875134 DOI: 10.4103/jcecho.jcecho_32_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Left ventricular remodeling (LVR) after ST-elevation myocardial infarction (STEMI) harbingers poor prognosis. Three-dimensional echocardiography (3DE) is more accurate than 2 D echo for the assessment of left ventricle (LV) shape. We assessed LV geometry with 3D ECHO 6 months after STEMI in patients who had primary angioplasty. Materials and Methods In this prospective study, morphological and functional analysis of LV with 3D ECHO (volumes, LVEF, 3D sphericity index [SI]) was assessed up to 7 days and 6 months in 42 STEMI patients. The LVR was considered for increase >15% of the end diastolic volume of the LV (LVEDV) 6 months after the STEMI, compared to the LVEDV up to 7 days of it. Results Sixteen (38%) patients had LVR. 3D Echocardiographic measurements up to 7 days after the acute myocardial infarction (AMI) 1-LVEDV in ventricular remodeling group was 99.8 ± 19.1 ml and in no ventricular remodeling group was 87 ± 18.2 mL (P = 0.037); 2-LVEF was 0.48 ± 0.01 and 51 ± 0.02 (P <.001); 3D-SI was 0.41 ± 0.05 and 31 ± 0.05 (P < 0.001) II-after 6 months: 1-LVEDV in remodeling group was 114.2 ± 19.5 mL and no remodeling group was 94.2 ± 18.6 (P = 0.002); 2-LVEF was 0.58 ± 0.01 and 59 ± .01 (P = 0.003); 3D-sphericity was 0.35 ± 0.05 and 28 ± .05 (P < 0.001). Conclusion LVR was observed in 38% of the patients 6 months after AMI. The 3D SI has been associated with occurrence of LVR and can differentiate patients with and without subsequent development of LVR accurately and early on its basis.
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Affiliation(s)
- Rakesh Kumar Ola
- Department of Cardiology, SMS Medical College, Jaipur, Rajasthan, India
| | | | | | - Ashish Agarwal
- Department of Cardiology, SMS Medical College, Jaipur, Rajasthan, India
| | - Smriti Bhargava
- Department of Cardiology, SMS Medical College, Jaipur, Rajasthan, India
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Abdel Aziz FM, Abdel Dayem SM, Ismail RI, Hassan H, Fattouh AM. Assessment of Left Ventricular Volume and Function Using Real-Time 3D Echocardiography versus Angiocardiography in Children with Tetralogy of Fallot. J Cardiovasc Ultrasound 2016; 24:123-7. [PMID: 27358704 PMCID: PMC4925389 DOI: 10.4250/jcu.2016.24.2.123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 04/26/2016] [Accepted: 05/10/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Evaluation of left ventricular (LV) size and function is one of the important reasons for performing echocardiography. Real time three dimensional echocardiography (RT3DE) is now available for a precise non-invasive ventricular volumetry. Aim of work was to validate RT3DE as a non-invasive cardiac imaging method for measurement of LV volumes using cardiac angiography as the reference technique. METHODS Prospective study on 40 consecutive patients with tetralogy of Fallot (TOF) referred for cardiac catheterization for preoperative assessment. Biplane cineangiography, conventional 2 dimensional echocardiography (2DE) and RT3DE were performed for the patients. A control group of 18 age and sex matched children was included and 2DE and RT3DE were performed for them. RESULTS The mean LV end diastolic volume (LVEDV) and LVEDV index (LVEDVI) measured by RT3DE of patients were lower than controls (p value = 0.004, 0.01, respectively). There was strong correlation between the mean value of the LVEDV and the LVEDVI measured by RT3DE and angiography (r = 0.97, p < 0.001). The mean value of LV ejection fraction measured by RT3DE was lower than that assessed by 2DE (50 ± 6.2%, 65 ± 4.6%, respectively, p value < 0.001) in the studied TOF cases. There was good intra- and inter-observer reliability for all measurements. CONCLUSION RT3DE is a noninvasive and feasible tool for measurement of LV volumes that strongly correlates with LV volumetry done by angiography in very young infants and children, and further studies needed.
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Affiliation(s)
| | | | - Reem I Ismail
- Department of Pediatrics, Cairo University, Cairo, Egypt
| | - Hebah Hassan
- Department of Pediatrics, National Research Centre, Cairo, Egypt
| | - Aya M Fattouh
- Department of Pediatrics, Cairo University, Cairo, Egypt
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Real-time three-dimensional echocardiography: never before clinical efficacy looked so picturesque. Int J Cardiol 2015; 198:15-21. [DOI: 10.1016/j.ijcard.2015.06.052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 05/04/2015] [Accepted: 06/18/2015] [Indexed: 11/20/2022]
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Vieira MLC, Oliveira WA, Cordovil A, Rodrigues ACT, Mônaco CG, Afonso T, Lira Filho EB, Perin M, Fischer CH, Morhy SS. 3D Echo pilot study of geometric left ventricular changes after acute myocardial infarction. Arq Bras Cardiol 2013; 101:43-51. [PMID: 23740401 PMCID: PMC3998181 DOI: 10.5935/abc.20130112] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 03/25/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Left ventricular remodeling (LVR) after AMI characterizes a factor of poor prognosis. There is little information in the literature on the LVR analyzed with three-dimensional echocardiography (3D ECHO). OBJECTIVE To analyze, with 3D ECHO, the geometric and volumetric modifications of the left ventricle (VE) six months after AMI in patients subjected to percutaneous primary treatment. METHODS Prospective study with 3D ECHO of 21 subjects (16 men, 56 ± 12 years-old), affected by AMI with ST segment elevation. The morphological and functional analysis (LV) with 3D ECHO (volumes, LVEF, 3D sphericity index) was carried out up to seven days and six months after the AMI. The LVR was considered for increase > 15% of the end diastolic volume of the LV (LVEDV) six months after the AMI, compared to the LVEDV up to seven days from the event. RESULTS Eight (38%) patients have presented LVR. Echocardiographic measurements (n = 21 patients): I- up to seven days after the AMI: 1- LVEDV: 92.3 ± 22.3 mL; 2- LVEF: 0.51 ± 0.01; 3- sphericity index: 0.38 ± 0.05; II- after six months: 1- LVEDV: 107.3 ± 26.8 mL; 2- LVEF: 0.59 ± 0.01; 3- sphericity index: 0.31 ± 0.05. Correlation coefficient (r) between the sphericity index up to seven days after the AMI and the LVEDV at six months (n = 8) after the AMI: r: 0.74, p = 0.0007; (r) between the sphericity index six months after the AMI and the LVEDV at six months after the AMI: r: 0.85, p < 0.0001. CONCLUSION In this series, LVR has been observed in 38% of the patients six months after the AMI. The three-dimensional sphericity index has been associated to the occurrence of LVR.
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Shakil O, Jainandunsing JS, Ilic R, Matyal R, Mahmood F. Ischemic Mitral Regurgitation: An Intraoperative Echocardiographic Perspective. J Cardiothorac Vasc Anesth 2013; 27:573-85. [DOI: 10.1053/j.jvca.2012.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Indexed: 11/11/2022]
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15
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Conte L, Fabiani I, Barletta V, Giannini C, Leo LA, Delle Donne MG, Palagi C, Nardi C, Dini FL, Petronio AS, Marzilli M, Di Bello V. The role of cardiovascular imaging to understand the different patterns of post-ischemic remodeling. J Cardiovasc Echogr 2012. [DOI: 10.1016/j.jcecho.2012.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Abstract
The evaluation of left ventricular systolic function is one of the most common reasons for referral for a non-invasive cardiac imaging study. In addition to its diagnostic and prognostic value, an assessment of ejection fraction can also be used to guide medical and device therapy. Thus, obtaining an accurate and reproducible assessment of LVEF is essential for patient management. This review will focus on novel multi-modality techniques used for the quantification of left ventricular systolic function. Emerging echocardiography techniques such as three-dimensional echocardiography and strain imaging and their incremental role over traditional 2D imaging will be discussed. In addition, new developments expanding nuclear imaging techniques' evaluation of left ventricular systolic function will be reviewed. Finally, an overview of advances in imaging techniques such as cardiac magnetic resonance and cardiac computed tomography, which now allow for an accurate and highly reproducible assessment of LVEF, will be presented.
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Affiliation(s)
- Sonal Chandra
- Non-invasive Cardiac Imaging Center, Section of Cardiology, University of Chicago Medical Center, 5841 S. Maryland Ave, MC 5084, Chicago, IL 60637, USA
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Kort S, Mamidipally S, Madahar P, Dave S, Brown DL. Real time three-dimensional stress echocardiography: a new approach for assessing diastolic function. Echocardiography 2011; 28:676-83. [PMID: 21718353 DOI: 10.1111/j.1540-8175.2011.01399.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess the feasibility of utilizing real time three-dimensional echocardiography (RT3DE) for assessment of diastolic function during stress. METHODS Rest and stress volumes were acquired in 24 patients and parameters of diastolic function-peak ventricular filling rate (PFR) and time to peak filling rate (TPFR)-were calculated. RESULTS Calculation of diastolic parameters was feasible in all patients. Resting PFR correlated with end-diastolic (EDV) and stroke volumes and inversely with TPFR (r = 0.53, 0.66, -0.5). With stress, PFR increased by 93% and TPFR decreased by 23% (P < 0.001). Stress PFR correlated with stress heart rate, EDV and stroke volume (r = 0.52, 0.50, 0.62) while TPFR correlated inversely with heart rate (r =-0.71). The change in PFR with stress correlated with the change in stroke volume (r = 0.42), while the change in TPFR correlated with the change in end-systolic volume (ESV) (r = 0.43) and inversely with the change in diastolic blood pressure (r =-0.41). Rest and stress PFR and TPFR are independent of age, gender and blood pressure and the change in PFR is independent of stress heart rate or blood pressure. E/E' correlated with stress TPFR (r = 0.72) and change in TPFR (r = 0.67) and inversely with change in PFR (r =-0.67). CONCLUSIONS RT3DE can assess diastolic function during stress by detecting changes in PFR and TPFR, independent of gender, age, and blood pressure. The changes in these parameters with stress are influenced by baseline filling pressures. Larger studies are required to validate the clinical significance of these observations.
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Affiliation(s)
- Smadar Kort
- Division of Cardiovascular Medicine, Stony Brook University Medical Center, Stony Brook, New York 11794, USA.
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van der Heide JA, Kleijn SA, Aly MFA, Slikkerveer J, Kamp O. Three-dimensional echocardiography for left ventricular quantification: fundamental validation and clinical applications. Neth Heart J 2011; 19:423-31. [PMID: 21584798 PMCID: PMC3189315 DOI: 10.1007/s12471-011-0160-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
One of the earliest applications of clinical echocardiography is evaluation of left ventricular (LV) function and size. Accurate, reproducible and quantitative evaluation of LV function and size is vital for diagnosis, treatment and prediction of prognosis of heart disease. Early three-dimensional (3D) echocardiographic techniques showed better reproducibility than two-dimensional (2D) echocardiography and narrower limits of agreement for assessment of LV function and size in comparison to reference methods, mostly cardiac magnetic resonance (CMR) imaging, but acquisition methods were cumbersome and a lack of user-friendly analysis software initially precluded widespread use. Through the advent of matrix transducers enabling real-time three-dimensional echocardiography (3DE) and improvements in analysis software featuring semi-automated volumetric analysis, 3D echocardiography evolved into a simple and fast imaging modality for everyday clinical use. 3DE provides the possibility to evaluate the entire LV in three spatial dimensions during the complete cardiac cycle, offering a more accurate and complete quantitative evaluation the LV. Improved efficiency in acquisition and analysis may provide clinicians with important diagnostic information within minutes. The current article reviews the methodology and application of 3DE for quantitative evaluation of the LV, provides the scientific evidence for its current clinical use, and discusses its current limitations and potential future directions.
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Affiliation(s)
- J. A. van der Heide
- Department of Cardiology 5F 003, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands
| | - S. A. Kleijn
- Department of Cardiology 5F 003, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands
- Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, the Netherlands
| | - M. F. A. Aly
- Department of Cardiology 5F 003, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands
| | - J. Slikkerveer
- Department of Cardiology 5F 003, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands
- Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, the Netherlands
| | - O. Kamp
- Department of Cardiology 5F 003, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands
- Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, the Netherlands
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Kapetanakis S, Bhan A, Murgatroyd F, Kearney MT, Gall N, Zhang Q, Yu CM, Monaghan MJ. Real-time 3D echo in patient selection for cardiac resynchronization therapy. JACC Cardiovasc Imaging 2011; 4:16-26. [PMID: 21232699 DOI: 10.1016/j.jcmg.2010.09.021] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 09/14/2010] [Accepted: 09/16/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVES this study investigated the use of 3-dimensional (3D) echo in quantifying left ventricular mechanical dyssynchrony (LVMD), its interhospital agreement, and potential impact on patient selection. BACKGROUND assessment of LVMD has been proposed as an improvement on conventional criteria in selecting patients for cardiac resynchronization therapy (CRT). Three-dimensional echo offers a reproducible assessment of left ventricular (LV) structure, function, and LVMD and may be useful in selecting patients for this intervention. METHODS we studied 187 patients at 2 institutions. Three-dimensional data from baseline and longest follow-up were quantified for volume, left ventricular ejection fraction (LVEF), and systolic dyssynchrony index (SDI). New York Heart Association (NYHA) functional class was assessed independently. Several outcomes from CRT were considered: 1) reduction in NYHA functional class; 2) 20% relative increase in LVEF; and 3) 15% reduction in LV end-systolic volume. Sixty-two cases were shared between institutions to analyze interhospital agreement. RESULTS there was excellent interhospital agreement for 3D-derived LV end-diastolic and end- systolic volumes, EF, and SDI (variability: 2.9%, 1%, 7.1%, and 7.6%, respectively). Reduction in NYHA functional class was found in 78.9% of patients. Relative improvement in LVEF of 20% was found in 68% of patients, but significant reduction in LV end-systolic volume was found in only 41.5%. The QRS duration was not predictive of any of the measures of outcome (area under the curve [AUC]: 0.52, 0.58, and 0.57 for NYHA functional class, LVEF, and LV end-systolic volume), whereas SDI was highly predictive of improvement in these parameters (AUC: 0.79, 0.86, and 0.66, respectively). For patients not fulfilling traditional selection criteria (atrial fibrillation, QRS duration <120 ms, or undergoing device upgrade), SDI had similar predictive value. A cutoff of 10.4% for SDI was found to have the highest accuracy for predicting improvement following CRT. CONCLUSIONS the LVMD quantification by 3D echo is reproducible between centers. SDI was an excellent predictor of response to CRT in this selected patient cohort and may be valuable in identifying a target population for CRT irrespective of QRS morphology and duration.
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Affiliation(s)
- Stamatis Kapetanakis
- Department of Cardiology, King’s College Hospital, Denmark Hill, London, United Kingdom
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20
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Shahgaldi K, Manouras A, Brodin LÅ, Winter R. Direct Measurement of Left Ventricular Outflow Tract Area Using Three-Dimensional Echocardiography in Biplane Mode Improves Accuracy of Stroke Volume Assessment. Echocardiography 2010; 27:1078-85. [DOI: 10.1111/j.1540-8175.2010.01197.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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21
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Kilner PJ, Geva T, Kaemmerer H, Trindade PT, Schwitter J, Webb GD. Recommendations for cardiovascular magnetic resonance in adults with congenital heart disease from the respective working groups of the European Society of Cardiology. Eur Heart J 2010; 31:794-805. [PMID: 20067914 PMCID: PMC2848324 DOI: 10.1093/eurheartj/ehp586] [Citation(s) in RCA: 280] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Revised: 11/09/2009] [Accepted: 12/07/2009] [Indexed: 11/12/2022] Open
Abstract
This paper aims to provide information and explanations regarding the clinically relevant options, strengths, and limitations of cardiovascular magnetic resonance (CMR) in relation to adults with congenital heart disease (CHD). Cardiovascular magnetic resonance can provide assessments of anatomical connections, biventricular function, myocardial viability, measurements of flow, angiography, and more, without ionizing radiation. It should be regarded as a necessary facility in a centre specializing in the care of adults with CHD. Also, those using CMR to investigate acquired heart disease should be able to recognize and evaluate previously unsuspected CHD such as septal defects, anomalously connected pulmonary veins, or double-chambered right ventricle. To realize its full potential and to avoid pitfalls, however, CMR of CHD requires training and experience. Appropriate pathophysiological understanding is needed to evaluate cardiovascular function after surgery for tetralogy of Fallot, transposition of the great arteries, and after Fontan operations. For these and other complex CHD, CMR should be undertaken by specialists committed to long-term collaboration with the clinicians and surgeons managing the patients. We provide a table of CMR acquisition protocols in relation to CHD categories as a guide towards appropriate use of this uniquely versatile imaging modality.
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22
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Vieira MLC, Oliveira WA, Cury AF, Cordovil A, Rodrigues ACT, Naccarato GAF, Monaco CG, Costa LPRB, Romano RB, Calatroia JR, Afonso TR, Tavares GMP, Guimarães LAB, Lira Filho EB, Perin MA, Fischer CH, Morhy SS. Relation between three-dimensional and two-dimensional echocardiography and biochemical analysis in patients with ST-segment elevation myocardial infarction percutaneously treated. EINSTEIN-SAO PAULO 2010; 8:53-61. [PMID: 26761753 DOI: 10.1590/s1679-45082010ao1438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Accepted: 12/22/2009] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The prognosis of patients with acute myocardial infarction depends on multiple features that can demonstrate myocardial injury degree (such as serum markers of cardiac necrosis), and also on adaptive mechanisms relative to the acute event. The aim of the study was to assess the relation between biochemical and echocardiographic findings from three-dimensional echocardiographic (3D Echo) analysis and echocardiographic two-dimensional (2D Echo) left ventricular ejection fraction in patients with ST-segment elevation acute myocardial infarction, submitted to primary percutaneous treatment. METHODS A prospective study with 2D Echo and 3D Echo of 23 patients (17 males, mean age of 57 ± 13 years) with ST-segment elevation acute myocardial infarction, primarily percutaneously treated (stent). Serum cardiac markers (creatine kinase MB, Troponin I and Myoglobin) and serum brain natriuretic peptide were compared to echocardiographic parameters (volumes, left ventricular ejection fraction and ventricular dyssynchrony index). The statistical analysis was performed using Pearson's correlation coefficient, 95% CI, p < 0.05, linear regression equation and Bland & Altman test. RESULTS Pearson's correlation coefficient (r)relative to 3D left ventricular ejection fraction: 1- brain natriuretic peptide: r: - 0.7427, p < 0.0001; 2- creatine kinase MB: r: - 0.660, p = 0.001. Left ventricular ejection fraction 2D (r) : 1- brain natriuretic peptide: r: - 0.5478, p = 0.001; 2- creatine kinase MB: r: - 0.4800, p < 0.0277. Other associations were not significant. CONCLUSIONS In this series, it was observed better correlation in regard to serum creatine kinase MB, brain natriuretic peptide and 3D Echo left ventricular ejection fraction, when compared to 2D Echo left ventricular ejection fraction.
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Affiliation(s)
| | | | - Alexandre Ferreira Cury
- Department of Echocardiography, Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, Brazil
| | - Adriana Cordovil
- Department of Echocardiography, Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, Brazil
| | - Ana Clara Tude Rodrigues
- Department of Echocardiography, Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, Brazil
| | | | - Claudia Gianini Monaco
- Department of Echocardiography, Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, Brazil
| | | | - Renata Barbara Romano
- Department of Echocardiography, Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, Brazil
| | - João Roberto Calatroia
- Diagnostic Cardiology and Clinical Neurophysiology, Diagnostic and Preventive Medicine, Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, Brazil
| | - Tania Regina Afonso
- Department of Echocardiography, Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, Brazil
| | | | | | - Edgar Bezerra Lira Filho
- Department of Echocardiography, Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, Brazil
| | - Marco Antonio Perin
- Cardiovascular Intervention, Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, Brazil
| | - Claudio Henrique Fischer
- Department of Echocardiography, Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, Brazil
| | - Samira Saady Morhy
- Diagnostic Cardiology and Clinical Neurophysiology, Diagnostic and Preventive Medicine, Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, Brazil
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Lane C, Dorian P, Ghosh N, Radina M, O’Donnell S, Thorpe K, Mangat I, Korley V, Pinter A. Limitations in the current screening practice of assessing left ventricular ejection fraction for a primary prophylactic implantable defibrillator in southern Ontario. Can J Cardiol 2010; 26:e118-24. [PMID: 20352140 PMCID: PMC2851474 DOI: 10.1016/s0828-282x(10)70358-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Accepted: 05/25/2009] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Screening echocardiography (ECHO) is commonly performed to determine whether the patient's left ventricular ejection fraction (LVEF) is appropriate for primary prophylactic implantable cardiac defibrillator (ICD) referral. However, radionuclide ventriculography (RNA) is used by many implantation centres for decision making. OBJECTIVE To determine whether current screening ECHO techniques are effective in identifying patients suitable for primary prophylactic ICD referral. METHODS Correlation, sensitivity, specificity and likelihood ratios (LRs) of semiquantitative and numerical quantitative ECHO LVEFs were calculated for predicting RNA LVEFs that met implantation criteria (LVEF less than 30% and less than 35%). RESULTS AND DISCUSSION Among 193 patients, the LRs for a semiquantitative ECHO predicting an RNA LVEF of less than 30% (negative LR was 0.21 to 0.69 and positive LR was 1.22 to 2.83) or RNA LVEF of less than 35% (negative LR was 0.24 to 0.73 and positive LR was 1.33 to 3.46) demonstrated that current screening ECHO techniques are ineffective. However, the positive predictive value of grade 4 ECHO was 93.0%, suggesting that these patients may not require further LVEF investigation before implantation. Among 102 patients, current quantitative ECHO techniques did not improve the screening characteristics. CONCLUSIONS Current screening ECHO techniques may not be adequate for screening patients for consideration of a primary prophylactic ICD, but a grade 4 ECHO finding has a high positive predictive value in meeting implantation LVEF criteria. Improved screening standards should increase the number of patients referred with appropriate LVEF for primary prophylactic ICD implantation.
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Affiliation(s)
- Christopher Lane
- Division of Cardiology, Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario
| | - Paul Dorian
- Division of Cardiology, Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario
| | - Nina Ghosh
- Division of Cardiology, Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario
| | - Maria Radina
- Division of Cardiology, Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario
| | - Suzan O’Donnell
- Division of Cardiology, Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario
| | - Kevin Thorpe
- Division of Cardiology, Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario
| | - Iqwal Mangat
- Division of Cardiology, Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario
| | - Victoria Korley
- Division of Cardiology, Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario
| | - Arnold Pinter
- Division of Cardiology, Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario
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24
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Laser KT, Bunge M, Hauffe P, Argueta JRP, Kelter-Klopping A, Barth P, Sarikouch S, Burchert W, Kececioglu D, Korperich H. Left ventricular volumetry in healthy children and adolescents: comparison of two different real-time three-dimensional matrix transducers with cardiovascular magnetic resonance. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2009; 11:138-48. [DOI: 10.1093/ejechocard/jep185] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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25
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Vieira MLC, Nomura CH, Tranchesi B, de Oliveira WA, Naccarato G, Serpa BS, Passos RBD, Funari MBG, Fischer CH, Morhy SS. Real-time three-dimensional echocardiographic left ventricular systolic assessment: side-by-side comparison with 64-slice multi-detector cardiac computed tomography. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2009; 11:257-63. [PMID: 19969534 DOI: 10.1093/ejechocard/jep199] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIMS To investigate by real-time 3D echocardiography (RT3DE) and cardiac computed tomography (CCT) the analysis of left ventricle ejection fraction (LVEF) and volumes. METHODS AND RESULTS A total of 67 patients (37 males, 55 +/- 11 years) were studied prospectively by RT3DE and by 64-slice CCT. RT3DE data: LVEF ranged from 30 to 78.6% (63.1 +/- 7.33); left ventricular end-diastolic volume (LVEDV) from 44.1 to 210 (104.9 +/- 29.7) mL; left ventricular end-systolic volume (LVESV) from 11.4 to 149 ( 38.9 +/- 19.3) mL. CCT data: LVEF ranged from 28 to 86% (66 +/- 8.4); LVEDV from 51 to 212 (110.3 +/- 31.2) mL; LVESV from 7 to 152 (38.2 +/- 19.2) mL. Correlations relative to RT3DE and CCT were: LVEF (r: 0.79, P < 0.0001); LVEDV (r: 0.82, P < 0.0001); and LVESV (r: 0.91, P < 0.0001). CONCLUSION It was observed adequate correlation between RT3DE and CCT ventricular systolic function and geometry assessment.
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Affiliation(s)
- Marcelo L C Vieira
- Echocardiography Sector, Hospital Israelita Albert Einstein, R. Cardoso de melo, 463, apt 21, Vila Olímpia, São Paulo 04548-002, Brazil.
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26
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Kleijn SA, van Dijk J, de Cock CC, Allaart CP, van Rossum AC, Kamp O. Assessment of Intraventricular Mechanical Dyssynchrony and Prediction of Response to Cardiac Resynchronization Therapy: Comparison between Tissue Doppler Imaging and Real-Time Three-Dimensional Echocardiography. J Am Soc Echocardiogr 2009; 22:1047-54. [PMID: 19647409 DOI: 10.1016/j.echo.2009.06.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2008] [Indexed: 11/16/2022]
Affiliation(s)
- Sebastiaan A Kleijn
- VU University Medical Center, Department of Cardiology, Amsterdam, The Netherlands.
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27
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Shahgaldi K, Gudmundsson P, Manouras A, Brodin LA, Winter R. Visually estimated ejection fraction by two dimensional and triplane echocardiography is closely correlated with quantitative ejection fraction by real-time three dimensional echocardiography. Cardiovasc Ultrasound 2009; 7:41. [PMID: 19706183 PMCID: PMC2747837 DOI: 10.1186/1476-7120-7-41] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Accepted: 08/25/2009] [Indexed: 02/18/2023] Open
Abstract
Background Visual assessment of left ventricular ejection fraction (LVEF) is often used in clinical routine despite general recommendations to use quantitative biplane Simpsons (BPS) measurements. Even thou quantitative methods are well validated and from many reasons preferable, the feasibility of visual assessment (eyeballing) is superior. There is to date only sparse data comparing visual EF assessment in comparison to quantitative methods available. The aim of this study was to compare visual EF assessment by two-dimensional echocardiography (2DE) and triplane echocardiography (TPE) using quantitative real-time three-dimensional echocardiography (RT3DE) as the reference method. Methods Thirty patients were enrolled in the study. Eyeballing EF was assessed using apical 4-and 2 chamber views and TP mode by two experienced readers blinded to all clinical data. The measurements were compared to quantitative RT3DE. Results There were an excellent correlation between eyeballing EF by 2D and TP vs 3DE (r = 0.91 and 0.95 respectively) without any significant bias (-0.5 ± 3.7% and -0.2 ± 2.9% respectively). Intraobserver variability was 3.8% for eyeballing 2DE, 3.2% for eyeballing TP and 2.3% for quantitative 3D-EF. Interobserver variability was 7.5% for eyeballing 2D and 8.4% for eyeballing TP. Conclusion Visual estimation of LVEF both using 2D and TP by an experienced reader correlates well with quantitative EF determined by RT3DE. There is an apparent trend towards a smaller variability using TP in comparison to 2D, this was however not statistically significant.
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Affiliation(s)
- Kambiz Shahgaldi
- Department of Cardiology, Karolinska University Hospital Huddinge, Stockholm, Sweden.
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28
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Maruyama Y, Toyama K, Sato S, Masaki N, Kirimura M, Yoshimoto N. Accuracy of three-dimensional echocardiography in patients with prior anteroseptal myocardial infarction. J Echocardiogr 2009; 7:9-15. [PMID: 27278074 DOI: 10.1007/s12574-008-0002-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2008] [Revised: 11/19/2008] [Accepted: 12/11/2008] [Indexed: 11/28/2022]
Abstract
BACKGROUND Echocardiography is the most feasible modality for monitoring cardiac volume and function. However, conventional two-dimensional echocardiography (2DE) is frequently not accurate in measuring cardiac performance in cases of abnormal left ventricular wall motion, because of the geometric assumptions. Quantitative gated scintigraphy and magnetic resonance imaging are reliable modalities, but are expensive and not feasible for repetitive use. Real-time three-dimensional echocardiography (RT3DE) has been proved to be applicable in daily practice. The purpose of this study was to confirm the superiority of RT3DE to 2DE in assessing cardiac volume and function in patients with abnormal wall motion. METHODS The subjects were 41 patients with old anteroseptal myocardial infarction who underwent left ventricular volume and functional measurement by RT3DE, 2DE, and left ventriculography (LVG). End-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) from RT3DE and 2DE were measured and compared with results from LVG. RESULTS RT3DE correlated well with LVG in measurements of EDV, ESV, and EF (r = 0.815, 0.940, and 0.812, respectively; P < 0.001 each). Likewise, 2DE correlated with LVG, but underestimated left ventricular volume, particularly EDV (r = 0.652, 0.909, and 0.761, respectively; P < 0.001 each). CONCLUSION Values derived from RT3DE were closer to those from LVG than were values derived from 2DE. RT3DE provides important information on cardiac function in patients with prior anteroseptal myocardial infarction.
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Affiliation(s)
- Yoshiaki Maruyama
- Department of Health Promotion, Saitama Medical Center, Saitama Medical University, 1981 Kamoda-Tsujidomachi, Kawagoe, 350-8550, Japan.
| | - Kentaro Toyama
- Department of Cardiology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda-Tsujidomachi, Kawagoe, 350-8550, Japan
| | - Shunichi Sato
- Department of Cardiology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda-Tsujidomachi, Kawagoe, 350-8550, Japan
| | - Nobuyuki Masaki
- Department of Cardiology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda-Tsujidomachi, Kawagoe, 350-8550, Japan
| | - Masato Kirimura
- Department of Cardiology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda-Tsujidomachi, Kawagoe, 350-8550, Japan
| | - Nobuo Yoshimoto
- Department of Cardiology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda-Tsujidomachi, Kawagoe, 350-8550, Japan
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29
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Tsai CT, Hung CL, Hou CJY, Hung TC, Yeh HI, Tsai CH. Real-Time Three-Dimensional Echocardiography in the Evaluation of Left Atrial Structure and Function in Normal, Aging, Hypertensive and Heart Failure Patients: New Insights into Left Atrial Adaptation and Remodeling. INT J GERONTOL 2009. [DOI: 10.1016/s1873-9598(09)70021-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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30
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Real-time three-dimensional echocardiographic assessment of left ventricular remodeling index in patients with hypertensive heart disease and coronary artery disease. JOURNAL OF HUAZHONG UNIVERSITY OF SCIENCE AND TECHNOLOGY. MEDICAL SCIENCES = HUA ZHONG KE JI DA XUE XUE BAO. YI XUE YING DE WEN BAN = HUAZHONG KEJI DAXUE XUEBAO. YIXUE YINGDEWEN BAN 2009; 29:122-6. [PMID: 19224178 DOI: 10.1007/s11596-009-0126-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Indexed: 01/19/2023]
Abstract
Left ventricular remodeling index (LVRI) was assessed in patients with hypertensive heart disease (HHD) and coronary artery disease (CAD) by real-time three-dimensional echocardiography (RT3DE). RT3DE data of 18 patients with HHD, 20 patients with CAD and 22 normal controls (NC) were acquired. Left ventricular end-diastolic volume (EDV) and left ventricular end-diastolic epicardial volume (EDVepi ) were detected by RT3DE and two-dimensional echocardiography Simpson biplane method (2DE). LVRI (left ventricular mass /EDV) was calculated and compared. The results showed that LVRI measurements detected by RT3DE and 2DE showed significant differences inter-groups (P<0.01). There was no significant difference in NC group (P>0.05), but significant difference in HHD and CAD intra-group (P<0.05). There was good positive correlations between LVRI detected by RT3DE and 2DE in NC and HHD groups (r=0.69, P<0.01; r=0.68, P<0.01), but no significant correlation in CAD group (r=0.30, P>0.05). It was concluded that LVRI derived from RT3DE as a new index for evaluating left ventricular remodeling can provide more superiority to LVRI derived from 2DE.
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Three-Dimensional Echocardiography. Echocardiography 2009. [DOI: 10.1007/978-1-84882-293-1_31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Kleijn SA, Kamp O. Clinical application of three-dimensional echocardiography: past, present and future. Neth Heart J 2009; 17:18-24. [PMID: 19148334 PMCID: PMC2626655 DOI: 10.1007/bf03086210] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Significant advances in three-dimensional echocardiography have made this modality a powerful diagnostic tool in the cardiology clinic. It can provide accurate and reliable measurements of chamber size and function, including the quantification of left ventricular mechanical dyssynchrony to guide patient selection for cardiac resynchron-isation therapy. Furthermore, three-dimensional echocardiography offers novel views and comprehensive anatomic definition of valvular and congenital abnormalities, improving diagnosis and preoperative planning. In addition, it is extremely useful in monitoring the effectiveness of surgical or percutaneous transcatheter interventions. As its efficacy for more and more clinical applications is demonstrated, it is clear that three-dimensional echocardiography has become part of the routine clinical diagnostic armamentarium. In this article, we describe the development of three-dimensional echocardiography over the last decades, review the scientific evidence for its current clinical use and discuss potential future applications. (Neth Heart J 2009;17:18-24.).
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Affiliation(s)
- S A Kleijn
- Department of Cardiology 4D 194, VU University Medical Center, Amsterdam, and Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, the Netherlands
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Mooij CF, de Wit CJ, Graham DA, Powell AJ, Geva T. Reproducibility of MRI measurements of right ventricular size and function in patients with normal and dilated ventricles. J Magn Reson Imaging 2008; 28:67-73. [PMID: 18581357 DOI: 10.1002/jmri.21407] [Citation(s) in RCA: 215] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
PURPOSE To determine the inter- and intraobserver reproducibility of cardiac magnetic resonance (CMR)-derived measurements of right ventricular (RV) mass, volume, and function in patients with normal and dilated ventricles. MATERIALS AND METHODS CMR studies of 60 patients in three groups were studied: a normal RV group (N = 20) and two groups with RV dilation-atrial septal defect (ASD) (N = 20) and repaired tetralogy of Fallot (TOF) (N = 20). Two independent observers analyzed each study on two separate occasions. Inter- and intraobserver reproducibility of biventricular mass, volume, ejection fraction (EF), and stroke volume (SV) measurements were calculated. RESULTS High intraclass correlation coefficients (ICC) were found for interobserver (ICC = 0.94-0.99) and intraobserver (ICC = 0.96-0.99) comparisons of RV and left ventricular (LV) mass, volume, and SV measurements. RV and LV EF measurements were less reproducible (ICC = 0.79-0.87). RV mass measurements were significantly less correlated than the respective LV measurements. Small but statistically significant differences in correlation were noted in RV measurements across groups. CONCLUSION Except for RV mass, inter- and intraobserver reproducibility of RV size and function measurements is high and generally comparable to that in the LV in patients with both normal and dilated RV.
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Affiliation(s)
- Christiaan F Mooij
- Department of Cardiology, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA
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Three-dimensional echocardiography for management of structural heart disease. CURRENT CARDIOVASCULAR RISK REPORTS 2008. [DOI: 10.1007/s12170-008-0066-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ostenfeld E, Shahgaldi K, Winter R, Willenheimer R, Holm J. Comparison of different views with three-dimensional echocardiography: apical views offer superior visualization compared with parasternal and subcostal views. Clin Physiol Funct Imaging 2008; 28:409-16. [PMID: 18691248 DOI: 10.1111/j.1475-097x.2008.00823.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Studies seeking to validate real-time three-dimensional echocardiography (3DE) with regard to cardiac function and dimensions have almost exclusively used apical views. However, it has never been examined whether apical views are preferable to parasternal or subcostal views. In the present study, we compared the feasibility of 3DE volumetric measurements of the four heart chambers in three different views. We included 40 patients planned for a routine two-dimensional transthoracic echocardiography examination (2DE). All patients were scanned with both 2DE and 3DE (Sonos 7500; Philips Medical Systems Andover, MA, USA). Parasternal, apical and subcostal views were used for 3DE. Volumes were calculated using manual tracing in 16 planes. 2DE was performed in parasternal longaxis, subcostal and apical four- and two-chamber views. Manual tracing was used for area calculations. To be judged fully traceable, 5/6 (85%) or more of the ventricular and atrial walls had to be adequately visualized in each plane. The left ventricle and left atrium were adequately visualized in the 3DE apical view in 34 (85%) and 40 (100%) patients, respectively. Visualization of the right atrium was adequate in 31 (78%) patients, whereas the right ventricle was adequately visualized in only 12 (30%) patients. The apical view of 3DE provided superior visualization of all four heart chambers compared with the parasternal and subcostal views, when applying a slight off-axis approach for both ventricles when needed. Thus, in the present study, there was no incremental value of assessment of chamber volumes in the parasternal and subcostal views.
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Affiliation(s)
- Ellen Ostenfeld
- Department of Cardiology, Malmö University Hospital, Lund University, Malmäo, Sweden.
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Mårtensson M, Winter R, Cederlund K, Ripsweden J, Mir-Akbari H, Nowak J, Brodin LA. Assessment of left ventricular volumes using simplified 3-D echocardiography and computed tomography - a phantom and clinical study. Cardiovasc Ultrasound 2008; 6:26. [PMID: 18533014 PMCID: PMC2426675 DOI: 10.1186/1476-7120-6-26] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Accepted: 06/04/2008] [Indexed: 11/10/2022] Open
Abstract
Objectives To compare the accuracy of simplified 3-dimensional (3-D) echocardiography vs. multi-slice computed tomography (MSCT) software for the quantification of left ventricular (LV) volumes. Design Three-D echocardiography (3-planes approach) and MSCT-CardIQ software were calibrated by measuring known volumes of 10 phantoms designed to closely mimic blood-endocardium interface. Subsequently, LV volumes were measured with both the methods in 9 patients referred routinely for coronary angiography and the agreement between the measurements was evaluated. Results Simplified 3D-echocardiography provided higher degree of agreement between the measured and true phantom volumes (mean difference 0 ± 1 ml, variation range +4 to -4 ml) than MSCT software (mean difference 6 ± 5 ml; variation range +22 to -10 ml). The agreement between LV measurements in the patients was considerably poorer, with significantly larger volumes produced by MSCT (mean difference -23 ± 40 ml, variation between +93 and -138 ml). Conclusion Simplified 3-D echocardiography provides more accurate assessment of phantom volumes than MSCT-CardIQ software. The discrepancy between the results of LV measurements with the two methods is even greater and does not warrant their interchangeable diagnostic use.
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Affiliation(s)
- Mattias Mårtensson
- School for Technology and Health, Royal Institute of Technology, Flemingsberg, Stockholm, Sweden.
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Shahgaldi K, Söderqvist E, Gudmundsson P, Winter R, Nowak J, Brodin LA. Flow-volume loops derived from three-dimensional echocardiography: a novel approach to the assessment of left ventricular hemodynamics. Cardiovasc Ultrasound 2008; 6:13. [PMID: 18394157 PMCID: PMC2322957 DOI: 10.1186/1476-7120-6-13] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2008] [Accepted: 04/04/2008] [Indexed: 11/30/2022] Open
Abstract
Background This study explores the feasibility of non-invasive evaluation of left ventricular (LV) flow-volume dynamics using 3-dimensional (3D) echocardiography, and the capacity of such an approach to identify altered LV hemodynamic states caused by valvular abnormalities. Methods Thirty-one patients with moderate-severe aortic (AS) and mitral (MS) stenoses (21 and 10 patients, respectively) and 10 healthy volunteers underwent 3D echocardiography with full volume acquisition using Philips Sonos 7500 equipment. The digital 3D data were post- processed using TomTec software. LV flow-volume loops were subsequently constructed for each subject by plotting instantaneous LV volume data sampled throughout the cardiac cycle vs. their first derivative representing LV flow. After correction for body surface area, an average flow-volume loop was calculated for each subject group. Results Flow-volume loops were obtainable in all subjects, except 3 patients with AS. The flow-volume diagrams displayed clear differences in the form and position of the loops between normal individuals and the respective patient groups. In patients with AS, an "obstructive" pattern was observed, with lower flow values during early systole and larger end-systolic volume. On the other hand, patients with MS displayed a "restrictive" flow-volume pattern, with reduced diastolic filling and smaller end-diastolic volume. Conclusion Non-invasive evaluation of LV flow-volume dynamics using 3D-echocardiographic data is technically possible and the approach has a capacity to identify certain specific types of alteration of LV flow-volume pattern caused by valvular abnormalities, thus reflecting underlying hemodynamic states specific for these abnormalities.
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Affiliation(s)
- Kambiz Shahgaldi
- Department of Cardiology, Karolinska University Hospital Huddinge, Stockholm, Sweden.
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van der Heide J, Mannaerts H, Yang L, Sieswerda G, Visser† C, Kamp O. Contrast-enhanced versus non-enhanced three-dimensional echocardiography of left ventricular volumes. Neth Heart J 2008; 16:47-52. [PMID: 18335021 PMCID: PMC2245811 DOI: 10.1007/bf03086117] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In three-dimensional echocardiography (3DE), individual endocardial trabeculae are not clearly visible necessitating left ventricular (LV) volumes to be measured by tracing the innermost endocardial contour. Ultrasound contrast agents aim to improve endocardial definition, but may delineate the outermost endocardial contour by filling up intertrabecular space. Although measurement reproducibility may benefit, there may be a significant influence on absolute LV volume measurements. METHODS Twenty patients with a recent myocardial infarction and good ultrasound image quality underwent 3DE using the TomTec Freehand method before and during continuous intravenous contrast infusion. LV volumes were measured offline using TomTec Echo-Scan software. RESULTS The use of contrast enhancement increased end-diastolic (110+/-35 vs. 144+/-53 ml; p<0.01) and end-systolic volume measurements (68+/-31 vs. 87+/-45 ml; p<0.01) significantly compared with non-contrast; the ejection fraction remained unchanged (40+/-13 vs. 41+/-14%, p=NS). Measurement reproducibility did not improve significantly, however. CONCLUSION Volumes measured by 3DE are significantly larger when ultrasound contrast is used. Possibly, intertrabecular space comprises a substantial part of the LV cavity. In the presence of an adequate apical acoustic window, ultrasound contrast does not improve LV volume measurement reproducibility. (Neth Heart J 2008;16:47-52.).
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Affiliation(s)
- J.A. van der Heide
- Department of Cardiology, VU University Medical Centre, Amsterdam, the Netherlands
| | - H.F.J. Mannaerts
- Department of Cardiology, VU University Medical Centre, Amsterdam, the Netherlands
| | - L. Yang
- Department of Cardiology, the Second Affiliated Hospital, Sun Yat-Sen University, Ghangzou, People’s Republic of China
| | - G.T. Sieswerda
- Department of Cardiology, VU University Medical Centre, Amsterdam, the Netherlands
| | - C.A. Visser†
- Department of Cardiology, VU University Medical Centre, Amsterdam, the Netherlands
| | - O. Kamp
- Department of Cardiology, VU University Medical Centre, Amsterdam, the Netherlands
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Real-time three-dimensional echocardiography in aortic stenosis: a novel, simple, and reliable method to improve accuracy in area calculation. Eur Heart J 2007; 29:1296-306. [PMID: 17989075 DOI: 10.1093/eurheartj/ehm467] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS The aim of the study was to validate a novel formula for aortic area, based on the principle of continuity equation (CE), that substitutes Doppler-derived stroke volume (SV) by SV directly measured with real-time three-dimensional (RT3D) echo and semi-automated border detection. RT3D has proved outstanding accuracy for left ventricular volume calculation. So far, however, neither this potential has been applied to haemodynamic assessment, nor RT3D has succeeded in the evaluation of aortic valve disease. METHODS AND RESULTS Aortic area was measured in 41 patients with aortic stenosis using Gorlin's equation, Hakki's formula, Doppler CE, two-dimensional Simpson's volumetric method, and by the novel RT3D method. RT3D has the best linear association and absolute agreement with Gorlin of all non-invasive methods r = 0.902, intraclass correlation coefficient (ICC) = 0.846, better than CE (r = 0.646, ICC = 0.626) and two-dimensional volumetric method (r = 0.627, ICC = 0.378). Linear and Passing-Bablok regression show that RT3D fits better to Gorlin (r(2) = 0.814) than CE (r(2) = 0.417) and two-dimensional method (r(2) = 0.393). Its accuracy is comparable to Hakki's formula, routinely employed in catheter laboratories. Inter- and intraobserver agreements (ICC) were, respectively, 0.732 and 0.985, better than CE (0.662, 0.857). RT3D also grades most efficiently the severity of aortic stenosis as mild, moderate, or severe (weighted kappa = 0.932). RT3D underestimates aortic area (95% CI 0.084-0.193). ROC curves, however, show that the optimal cutoff point to consider aortic stenosis severity remains close to 1 cm(2) (1.06 cm(2)). CONCLUSIONS RT3D is more accurate than CE and than two-dimensional volumetric methods to calculate area and to grade the severity of aortic stenosis. Area obtained by three-dimensional echo is slightly underestimated, but its range is clinically negligible.
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Tighe DA, Rosetti M, Vinch CS, Chandok D, Muldoon D, Wiggin B, Dahlberg ST, Aurigemma GP. Influence of Image Quality on the Accuracy of Real Time Three-Dimensional Echocardiography to Measure Left Ventricular Volumes in Unselected Patients: A Comparison with Gated-SPECT Imaging. Echocardiography 2007; 24:1073-80. [DOI: 10.1111/j.1540-8175.2007.00525.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Yao GH, Li F, Zhang C, Zhang PF, Zhang M, Zhao YX, Li XN, Ding SF, Zhong L, Zhang Y. How many planes are required to get an accurate and timesaving measurement of left ventricular volume and function by real-time three-dimensional echocardiography in acute myocardial infarction? ULTRASOUND IN MEDICINE & BIOLOGY 2007; 33:1572-8. [PMID: 17566637 DOI: 10.1016/j.ultrasmedbio.2007.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2006] [Revised: 04/18/2007] [Accepted: 04/25/2007] [Indexed: 05/15/2023]
Abstract
To derive the optimal cutting planes of real-time 3-D echocardiography (RT-3DE) for measuring left ventricular volume and ejection fraction (EF) in the presence of left ventricular regional wall motion abnormalities, 14 open-chest dogs were studied with RT-3DE full volume imaging and 2-D echocardiography (2DE) after left anterior descending coronary arteries were occluded for 90 min. Left ventricular end diastolic volume (EDV), end systolic volume (ESV), stroke volume (SV) and EF were measured off-line with 2DE and RT-3DE (2-, 4- and 8-plane) methods. The autopsy EDV was estimated by the volume of saline solution injected into the excised heart and served as the reference volume (RefV) for comparison with EDV measured by 2DE and RT-3DE. Agreement analysis was performed according to the method of Bland and Altman. There were excellent correlations between 2DE, RT-3DE (2-plane) and RT-3DE (4-plane) methods on one hand, and RT-3DE (8-plane) method on the other in the measurements of EDV, ESV and SV (r = 0.84-0.99). However, 2DE and RT-3DE (2-plane) measurements significantly underestimated RT-3DE (8-plane) (p < 0.01), whereas no significant differences between RT-3DE (4-plane) and RT-3DE (8-plane) were found in terms of EDV, ESV and SV measurements. The values of EF determined by 2DE, RT-3DE (2-plane) and RT-3DE (4-plane) methods correlated highly with that by RT-3DE (8-plane) (r = 0.82-0.98) and there was no significant difference between the two measurements. EDV values determined by 2DE, RT-3DE (2-plane), RT-3DE (4-plane) and RT-3DE (8-plane) correlated highly with RefV (r = 0.84, r = 0.92, r = 0.94 and r = 0.97, respectively) and there was no significant difference between RefV and EDV by RT-3DE (4-plane) and RT-3DE (8-plane). In contrast, EDV measured by 2DE and RT-3DE (2-plane) methods underestimated RefV significantly (p < 0.01). In conclusion, RT-3DE allows reliable and reproducible measurement of left ventricular volume and EF, even in the presence of left ventricular regional wall motion abnormalities. RT-3DE (4-plane) is the method of choice for an accurate and timesaving quantification of left ventricular volume and function.
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Affiliation(s)
- Gui-Hua Yao
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong, China
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Gopal AS, Chukwu EO, Mihalatos DG, Katz AS, Mathew ST, Lachmann JS, Toole RS, Schapiro W, Reichek N. Left Ventricular Structure and Function for Postmyocardial Infarction and Heart Failure Risk Stratification by Three-dimensional Echocardiography. J Am Soc Echocardiogr 2007; 20:949-58. [DOI: 10.1016/j.echo.2007.01.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2006] [Indexed: 11/25/2022]
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Hung J, Lang R, Flachskampf F, Shernan SK, McCulloch ML, Adams DB, Thomas J, Vannan M, Ryan T. 3D echocardiography: a review of the current status and future directions. J Am Soc Echocardiogr 2007; 20:213-33. [PMID: 17336747 DOI: 10.1016/j.echo.2007.01.010] [Citation(s) in RCA: 193] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Judy Hung
- Massachusetts General Hospital, Boston, MA, USA
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Voormolen MM, Krenning BJ, van Geuns RJ, Borsboom J, Lancée CT, ten Cate FJ, Roelandt JR, van der Steen AF, de Jong N. Efficient Quantification of the Left Ventricular Volume Using 3-Dimensional Echocardiography: The Minimal Number of Equiangular Long-axis Images for Accurate Quantification of the Left Ventricular Volume. J Am Soc Echocardiogr 2007; 20:373-80. [DOI: 10.1016/j.echo.2006.09.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2006] [Indexed: 11/25/2022]
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Malm S, Frigstad S, Sagberg E, Steen PA, Skjarpe T. Real-time Simultaneous Triplane Contrast Echocardiography Gives Rapid, Accurate, and Reproducible Assessment of Left Ventricular Volumes and Ejection Fraction: A Comparison with Magnetic Resonance Imaging. J Am Soc Echocardiogr 2006; 19:1494-501. [PMID: 17138035 DOI: 10.1016/j.echo.2006.06.021] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2006] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We sought to compare the feasibility, accuracy, and reproducibility of simultaneous triplane echocardiography for measurements of left ventricular (LV) volumes and ejection fraction (EF) with reference to magnetic resonance imaging (MRI). METHODS Digital echocardiography recordings of apical LV views with and without intravenous contrast were collected from 53 consecutive patients with conventional 2-dimensional (2D) imaging and with simultaneous triplane imaging. MRI of multiple LV short-axis sections was performed with a 1.5-T scanner. Endocardial borders were manually traced, and LV volumes and EF from 2D biplane echocardiography and MRI were calculated by method of disks. On triplane data, a triangular mesh was constructed by 3-dimensional interpolation and volumes calculated by the divergence theorem. RESULTS Triplane image acquisition was less time-consuming than 2D biplane. Precontrast feasibility was 72% for triplane and 82% for 2D biplane images, increasing to 98% and 100% with contrast, respectively. Bland-Altman analysis demonstrated LV volume underestimation by echocardiography versus MRI, which was significantly reduced by contrast and triplane imaging. The 95% limits of agreement for EF between echocardiography and MRI narrowed using triplane compared with 2D biplane (precontrast -12.5 to 6.7% vs -17.2 to 9.9%, and with contrast -7.1 to 5.8% vs -9.4 to 6.4%, respectively). At intraobserver and interobserver analysis of 20 patients, limits of agreement for EF narrowed with contrast triplane compared with 2D biplane. CONCLUSION Simultaneous LV triplane imaging is feasible with simple and rapid image acquisition and volume analysis, and with contrast enhancement it gives accurate and reproducible LV EF measurements compared with MRI.
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Affiliation(s)
- Siri Malm
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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Krenning BJ, Voormolen MM, van Geuns RJ, Vletter WB, Lancée CT, de Jong N, Ten Cate FJ, van der Steen AFW, Roelandt JRTC. Rapid and Accurate Measurement of Left Ventricular Function with a New Second-Harmonic Fast-Rotating Transducer and Semi-Automated Border Detection. Echocardiography 2006; 23:447-54. [PMID: 16839381 DOI: 10.1111/j.1540-8175.2006.00241.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Measurement of left ventricular (LV) volume and function are the most common clinical referral questions to the echocardiography laboratory. A fast, practical, and accurate method would offer important advantages to obtain this important information. To validate a new practical method for rapid measurement of LV volume and function. We developed a continuous fast-rotating transducer, with second-harmonic capabilities, for three-dimensional echocardiography (3DE). Fifteen cardiac patients underwent both 3DE and magnetic resonance imaging (reference method) on the same day. 3DE image acquisition was performed during a 10-second breath-hold with a frame rate of 100 frames/sec and a rotational speed of 6 rotations/sec. The individual images were postprocessed with Matlab software using multibeat data fusion. Subsequently, with these images, 12 datasets per cardiac cycle were reconstructed, each comprising seven equidistant cross-sectional images for analysis in the new TomTec 4DLV analysis software, which uses a semi-automated border detection (ABD) algorithm. The ABD requires an average analysis time of 15 minutes per patient. A strong correlation was found between LV end-diastolic volume (r = 0.99; y = 0.95x - 1.14 ml; SEE = 6.5 ml), LV end-systolic volume (r = 0.96; y = 0.89x + 7.91 ml; SEE = 7.0 ml), and LV ejection fraction (r = 0.93; y = 0.69x + 13.36; SEE = 2.4%). Inter- and intraobserver agreement for all measurements was good. The fast-rotating transducer with new ABD software is a dedicated tool for rapid and accurate analysis of LV volume and function.
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Affiliation(s)
- Boudewijn J Krenning
- Department of Cardiology, Thoraxcenter and Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
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Jacobs LD, Salgo IS, Goonewardena S, Weinert L, Coon P, Bardo D, Gerard O, Allain P, Zamorano JL, de Isla LP, Mor-Avi V, Lang RM. Rapid online quantification of left ventricular volume from real-time three-dimensional echocardiographic data. Eur Heart J 2005; 27:460-8. [PMID: 16319085 DOI: 10.1093/eurheartj/ehi666] [Citation(s) in RCA: 260] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS Determination of left ventricular (LV) volumes and ejection fraction (EF) from two-dimensional echocardiographic (2DE) images is subjective, time-consuming, and relatively inaccurate because of foreshortened views and the use of geometric assumptions. Our aims were (1) to validate a new method for rapid, online measurement of LV volumes from real-time three-dimensional echocardiographic (RT3DE) data using cardiac magnetic resonance (CMR) as the reference and (2) to compare its accuracy and reproducibility with standard 2DE measurements. METHODS AND RESULTS CMR, 2DE, and RT3DE datasets were obtained in 50 patients. End-systolic and end-diastolic volumes (ESV and EDV) were calculated from the 2DE images using biplane method of disks. ES and ED RT3DE datasets were analysed using prototype software designed to automatically detect the endocardial surface using a deformable shell model and calculate ESV and EDV from voxel counts. 2DE and RT3DE-derived volumes were compared with CMR (linear regression, Bland-Altman analysis). In most patients, analysis of RT3DE data required <2 min per patient. RT3DE measurements correlated highly with CMR (r: 0.96, 0.97, and 0.93 for EDV, ESV, and EF, respectively) with small biases (-14 mL, -6.5 mL, -1%) and narrow limits of agreement (SD: 17 mL, 16 mL, 6.4%). 2DE measurements correlated less well with CMR (r: 0.89, 0.92, 0.86) with greater biases (-23 mL, -15 mL, 1%) and wider limits of agreement (SD: 29 mL, 24 mL, 9.5%). RT3DE resulted in lower intra-observer (EDV: 7.9 vs. 23%; ESV: 7.6 vs. 26%) and inter-observer variability (EDV: 11 vs. 26%; ESV: 13 vs. 31%). CONCLUSION Semi-automated detection of the LV endocardial surface from RT3DE data is suitable for clinical use because it allows rapid, accurate, and reproducible measurements of LV volumes, superior to conventional 2DE methods.
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Affiliation(s)
- Lawrence D Jacobs
- Noninvasive Cardiac Imaging Laboratory, University of Chicago Hospitals, 5841 S. Maryland Avenue, MC 5084, Chicago, IL 60637, USA
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van Stralen M, Bosch JG, Voormolen MM, van Burken G, Krenning BJ, van Geuns RJM, Lancée CT, de Jong N, Reiber JHC. Left ventricular volume estimation in cardiac three-dimensional ultrasound: a semiautomatic border detection approach. Acad Radiol 2005; 12:1241-9. [PMID: 16179201 DOI: 10.1016/j.acra.2005.06.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2004] [Revised: 06/03/2005] [Accepted: 06/27/2005] [Indexed: 01/20/2023]
Abstract
RATIONALE AND OBJECTIVES We propose a semiautomatic endocardial border detection method for three-dimensional (3D) time series of cardiac ultrasound (US) data based on pattern matching and dynamic programming, operating on two-dimensional (2D) slices of the 3D plus time data, for the estimation of full cycle left ventricular volume, with minimal user interaction. MATERIALS AND METHODS The presented method is generally applicable to 3D US data and evaluated on data acquired with the Fast Rotating Ultrasound (FRU-) Transducer, developed by Erasmus Medical Center (Rotterdam, the Netherlands), a conventional phased-array transducer, rotating at very high speed around its image axis. The detection is based on endocardial edge pattern matching using dynamic programming, which is constrained by a 3D plus time shape model. It is applied to an automatically selected subset of 2D images of the original data set, for typically 10 equidistant rotation angles and 16 cardiac phases (160 images). Initialization requires the drawing of four contours per patient manually. We evaluated this method on 14 patients against MRI end-diastole and end-systole volumes. Initialization requires the drawing of four contours per patient manually. We evaluated this method on 14 patients against MRI end-diastolic (ED) and end-systolic (ES) volumes. RESULTS The semiautomatic border detection approach shows good correlations with MRI ED/ES volumes (r = 0.938) and low interobserver variability (y = 1.005x - 16.7, r = 0.943) over full-cycle volume estimations. It shows a high consistency in tracking the user-defined initial borders over space and time. CONCLUSIONS We show that the ease of the acquisition using the FRU-transducer and the semiautomatic endocardial border detection method together can provide a way to quickly estimate the left ventricular volume over the full cardiac cycle using little user interaction.
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Affiliation(s)
- Marijn van Stralen
- Division of Image Processing, Department of Radiology, C2S, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
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Angelini ED, Homma S, Pearson G, Holmes JW, Laine AF. Segmentation of real-time three-dimensional ultrasound for quantification of ventricular function: a clinical study on right and left ventricles. ULTRASOUND IN MEDICINE & BIOLOGY 2005; 31:1143-58. [PMID: 16176781 DOI: 10.1016/j.ultrasmedbio.2005.03.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2004] [Revised: 03/14/2005] [Accepted: 03/22/2005] [Indexed: 05/04/2023]
Abstract
Among screening modalities, echocardiography is the fastest, least expensive and least invasive method for imaging the heart. A new generation of three-dimensional (3-D) ultrasound (US) technology has been developed with real-time 3-D (RT3-D) matrix phased-array transducers. These transducers allow interactive 3-D visualization of cardiac anatomy and fast ventricular volume estimation without tomographic interpolation as required with earlier 3-D US acquisition systems. However, real-time acquisition speed is performed at the cost of decreasing spatial resolution, leading to echocardiographic data with poor definition of anatomical structures and high levels of speckle noise. The poor quality of the US signal has limited the acceptance of RT3-D US technology in clinical practice, despite the wealth of information acquired by this system, far greater than with any other existing echocardiography screening modality. We present, in this work, a clinical study for segmentation of right and left ventricular volumes using RT3-D US. A preprocessing of the volumetric data sets was performed using spatiotemporal brushlet denoising, as presented in previous articles Two deformable-model segmentation methods were implemented in 2-D using a parametric formulation and in 3-D using an implicit formulation with a level set implementation for extraction of endocardial surfaces on denoised RT3-D US data. A complete and rigorous validation of the segmentation methods was carried out for quantification of left and right ventricular volumes and ejection fraction, including comparison of measurements with cardiac magnetic resonance imaging as the reference. Results for volume and ejection fraction measurements report good performance of quantification of cardiac function on RT3-D data compared with magnetic resonance imaging with better performance of semiautomatic segmentation methods than with manual tracing on the US data.
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Affiliation(s)
- Elsa D Angelini
- Ecole Nationale Supérieure des Télécommunications, Paris, France
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Gutiérrez-Chico JL, Zamorano JL, Pérez de Isla L, Orejas M, Almería C, Rodrigo JL, Ferreirós J, Serra V, Macaya C. Comparison of left ventricular volumes and ejection fractions measured by three-dimensional echocardiography versus by two-dimensional echocardiography and cardiac magnetic resonance in patients with various cardiomyopathies. Am J Cardiol 2005; 95:809-13. [PMID: 15757621 DOI: 10.1016/j.amjcard.2004.11.046] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2004] [Revised: 11/22/2004] [Accepted: 11/22/2004] [Indexed: 12/20/2022]
Abstract
End-diastolic volume and end-systolic volume were measured in 35 consecutive patients with cardiomyopathy using 2-dimensional (2-D) and 3-dimensional (3-D) echocardiography (2, 4, and 8 planes) and cardiac magnetic resonance imaging. Three-dimensional echocardiography correlates better with magnetic resonance imaging than does 2-D echocardiography. Its accuracy improves with the increase in the number of planes used. Two-dimensional echocardiography underestimates volumes, mainly in the subgroup with an ejection fraction of <50%, whereas 3-D echocardiography does not, if enough planes are used. However, in patients with an end-diastolic volume > or =150 ml, the underestimation of 3-D echocardiography is statistically significant. Increasing the number of planes to 8 reduces this bias. Conversely, patients with an end-diastolic volume <150 ml are accurately studied with just 4 planes.
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