A SIMPLIFIED, PRACTICAL ECHOCARDIOGRAPHIC APPROACH FOR 3-DIMENSIONAL SURFACING AND QUANTITATION OF THE LEFT-VENTRICLE - CLINICAL-APPLICATION IN PATIENTS WITH ABNORMALLY SHAPED HEARTS

The goal of this study was to validate the quantitative accuracy of a system for 3-dimensional (3D) echocardographic reconstruction of the l eft ventricle to assess its volume and function In human beings by usi ng 3 apical views as a simplified technique to promote practical clini cal application. End-diastolic and end-systolic volumes (EDV, ESV) and ejection fraction CEF) were obtained by 3D echocardiography in 50 pat ients with dilated or geometrically distorted left ventricles and comp ared with values from magnetic resonance imaging (20 consecutive patie nts), angiography (22 consecutive patients), and radionuclide imaging (8 consecutive patients). Three-dimensional results were also compared with 2-dimensional (2D) echocardiographic estimates. Three-dimensiona l left ventricular reconstruction provided values that correlated and agreed well with pooled data from the other techniques for EDV (y = 0. 93x + 9.1, r = 0.95, standard error of the estimate [SEE] = 15.2 mL, m ean difference = -0.5 +/- 15.4 mL, ESV (y = 0 94x + 4.3, r = 0.96, SEE = 11.4 mL, mean difference = 0.4 +/- 11.5 mI), and EF (y = 0.90x + 4. 1, r = 0.92, SEE = 6.2%, mean difference = -0.9 +/- 6.4%) (all mean di fferences not significant versus 0), with greater errors by 2D echocar diography. Intraobserver and interobserver variabilities of 3D echocar diography were less than 6% for EDV, ESV, and EE The overall time for image acquisition and 3D reconstruction was 5 to 8 minutes. Although t his 3D method uses only a small number of apical views, It accurately calculates EDV, ESV, and EF in patients with dilated and asymmetric le ft ventricles and Is more accurate than 2D echocardiography. The flexi ble surface fit used to combine the 3 views provides a convenient visu al output as well as quantitation. This simple and rapid 3D method has the potential to facilitate routine clinical applications that assess left ventricular function acid changes that occur with remodeling.