Anatomic validation of a novel method for left ventricular volume and massmeasurements with use of real-time 3-dimensional echocardiography

Assessment of left ventricular (LV) volumes and mass is a critical element in the evaluation of patients with cardiovascular disease. However, most no ninvasive methods used for the quantitative measurements of LV volume and m ass have important intrinsic Limitations. Real-time 3-dimensional echocardi ography (RT3D echo) is a new technique capable of acquiring volumetric Imag es without cardiac or respiratory gating. The purpose of this study was to develop and validate a system for rapid LV volume and mass measurements wit h the use of RT3D echo images. To this end, in 11 explanted sheep hearts, t he left ventricle was instrumented with a latex balloon and filled with kno wn volumes of saline solution. Two independent observers made volume calcul ations from Images acquired with RTSD echo. In addition, 21 open-chest shee p were Imaged with RT3D echo for LV mass calculation. Anatomic LV mass was determined after removing the heart. A strong correlation was observed betw een the actual LV volumes and those calculated from the RT3D echo Images (r = 0.99; y = 1.31 + 0.98x; standard error of the estimate = 2.2 mL). An ana lysis of intraobserver and interobserver variabilities revealed high indexe s of agreement. A strong correlation was observed between actual LV mass an d that calculated from RT3D echo images (r = 0.94; y = 14.4 + 0.89x; standa rd error of the estimate = 8.5 gm). Thus RTSD echo images allow rapid and a ccurate measurements of LV volume and mass. This technique may expand the u se of cardiac ultrasonography for the quantitative assessment of heart dise ase.