Three-dimensional echocardiographic measurement of left ventricular mass: Comparison with magnetic resonance imaging and two-dimensional echocardiographic determinations in man

This study was performed to compare a novel three-dimensional echocardiogra phy (3DE) system to clinical two-dimensional echocardiography (2DE) and mag netic resonance imaging (MRI) for determination of left ventricular mass (L VM) in humans. LVM is an independent predictor of cardiac morbidity and mor tality. Echocardiography is the most widely used clinical method for assess ment of LVM, as it is non-invasive, portable and relatively inexpensive. Ho wever, when measuring LVM, 2DE is limited by assumptions about ventricular shape which do not affect 3D echo. Methods: A total of 25 unselected patien ts underwent 3DE, 2DE and MRI. Three-dimensional echo used a magnetic scanh ead tracker allowing unrestricted selection and combination of images from multiple acoustic windows. Mass by quantitative 2DE was assessed using seve n different geometric formulas. Results: LVM by MRI ranged from 91 to 316 g . There was excellent agreement between 3DE and MRI (r = 0.99, SEE = 6.9 g) . Quantitative 2D methods correlated well with but underestimated MRI (r = 0.84-0.92) with SEEs over threefold greater (22.5-30.8 g). Interobserver va riation was 7.6% for 3DE vs. 17.7% for 2DE. Conclusions: LVM in humans can be measured accurately, relative to MRI, by transthoracic 3D echo using mag netic tracking. Compared to 2D echo, 3D echocardiography significantly impr oves accuracy and reproducibility.