COMPARISON OF 3-DIMENSIONAL ECHOCARDIOGRAPHIC ASSESSMENT OF VOLUME, MASS, AND FUNCTION IN CHILDREN WITH FUNCTIONALLY SINGLE LEFT-VENTRICLESWITH 2-DIMENSIONAL ECHOCARDIOGRAPHY AND MAGNETIC-RESONANCE-IMAGING

Diminished systolic function or inappropriate hypertrophy are consider ed risk factors for outcome following the Fontan procedure. These para meters are difficult to assess in univentricular hearts that do not co nform to the uniform shapes prescribed by conventional 2-dimensional i maging volume algorithms. Three-dimensional echocardiography requires no geometric assumptions and has been validated in both normal and dis torted left ventricles. To assess the feasibility and accuracy of this technique in patients with univentricular hearts, we compared 2- and 3-dimensional echocardiographic estimates of ventricular volume, elect ion fraction, and mass in patients with functionally single left ventr icles with results obtained by magnetic resonance imaging (MRI). Twelv e patients with functionally single left ventricles (6 months to 22 ye ars) underwent examination by all 3 modalities. Correlation and agreem ent with MRI were calculated for volumes, election fraction, and mass. Three-dimensional echocardiographic comparison with MRI yielded a bia s of 3.4 +/- 5.5 ml and 14.2 +/- 8.3 ml for systolic and diastolic vol umes, respectively. Agreement analysis for mass showed a bias of 5.8 /- 8.4 grams. Two-dimensional echocardiography showed less agreement f or both volumes and mass (bias of -2.9 +/- 8.1, 2.9 +/- 10.4 ml and -8 .3 +/- 12.0 g for volume and mass, respectively, p >0.05), Ejection fr action by 3-dimensional echocardiography showed significantly closer a greement with MRI (bias of 4.4 +/- 5.3%) than 2-dimensional echocardio graphy (bias of 8.5 +/- 10.3%, p = 0.04). Thus, 3-dimensional echocard iography provides estimates of ventricular volumes, election fraction, and mass that are comparable to MRI in this select group of patients with single ventricles of left ventricular morphology. (C) 1997 by Exc erpta Medica, Inc.