QUANTITATION OF LEFT-VENTRICULAR VOLUMES AND EJECTION FRACTION IN POSTINFARCTION PATIENTS FROM BIPLANE AND SINGLE PLANE 2-DIMENSIONAL ECHOCARDIOGRAMS - A PROSPECTIVE LONGITUDINAL-STUDY OF 371 PATIENTS

Aims To determine whether left ventricular volumes and ejection fracti ons calculated from single plane two-dimensional echocardiograms using the algorithm (0.85A(2)L) correlate with those calculated using the b iplane Simpson's method, and whether small changes in volumes and ejec tion fraction occurring post-infarction could be detected from single- plane as well as from biplane two-dimensional echocardiograms. Methods and Results Serial two-dimensional echocardiograms were obtained in 3 71 patients from the DEFIANT II trial a mean of 2 days, 1 week and 6 m onths post-infarction. Single plane volumes from the apical four chamb er and apical long axis correlated closely with biplane Simpson's left ventricular volumes. Both single-plane left ventricular volumes signi ficantly over-estimated biplane Simpson's volumes. Biplane Simpson's e jection fractions were consistently slightly under-estimated from the single-plane images. Differences between biplane Simpson's and single- plane volumes increased independently with increasing left ventricular size and distortion. The small changes in left ventricular volumes an d ejection fraction over time were as reliably detected from single pl ane as from biplane images. Conclusion Single-plane left ventricular v olumes overestimate biplane Simpson's volumes and under-estimate eject ion fraction, and these discrepancies are amplified in dilated hearts with abnormal shape.