QUANTITATIVE 3-DIMENSIONAL ECHOCARDIOGRAPHY IN PATIENTS WITH PULMONARY-HYPERTENSION AND COMPRESSED LEFT-VENTRICLES - COMPARISON WITH CROSS-SECTIONAL ECHOCARDIOGRAPHY AND MAGNETIC-RESONANCE-IMAGING

Objective-To evaluate the accuracy of quantitative three dimensional e chocardiography in patients with deformed left ventricles Design-Three dimensional and cross sectional echocardiographic estimates of left v entricular volume and ejection fraction were prospectively compared to those obtained from magnetic resonance imaging. Setting-Echocardiogra phy laboratory of a university hospital. Patients-26 patients (9 month s to 42 years, median age 11 years) with pulmonary hypertension and fi xed reversal of normal interventricular septal curvature.Main outcome measures-Left ventricular end diastolic and end systolic volumes and e jection fraction. Results-Three dimensional echocardiographic comparis on to magnetic resonance imaging (MRI) yielded r values of 0.94 and 0. 87 with a bias of - 6.9 (SD 6.9) ml and - 16 (11.2) ml for systolic an d diastolic volumes respectively. Interobserver variability was minima l (8.3% and 7.6% respectively). Cross sectional echocardiography gave correlation coefficients of 0.62 and 0.80 and bias of 3.1 (14.1) ml an d 16.3 (18.3) ml for systolic and diastolic volumes respectively. Ejec tion fraction by three dimensional echocardiography also had closer ag reement with MRI (bias = 1.1 (7.7)%) than cross sectional echocardiogr aphy (bias = 4.4 (13.9)%). Conclusions-Three dimensional echocardiogra phy provides reliable estimates of left ventricular volumes and ejecti on fraction, comparable to magnetic resonance imaging in pulmonary hyp ertension patients with compressed ventricular geometry. Because it el iminates the need for geometric assumptions it shows closer agreement with magnetic resonance imaging in that setting than cross sectional e chocardiography.