The validation of volumetric real-time 3-dimensional echocardiography for the determination of left ventricular function

The objective of this study was to validate a real-time 3-dimensional echoc ardiography (3DE) technique for the determination of left ventricular (IV) volume and ejection fraction (EF). in 10 mongrel dogs, an electromagnetic f low (EMT) probe was placed on the aorta, and the thorax was closed. Transth oracic imaging was performed during multiple hemodynamic conditions (n = 58 ) with simultaneous measurement of stroke volume (SV) with the use of EMT. From the volumetric data set, LV volumes were manually traced off-line by 2 independent observers with an apical. rotation method (6 planes) and a con ventional method (biplane) in a subset of conditions. This tracing techniqu e was also evaluated in 18 human subjects in whom the calculated EF values were compared with values derived by multigated radionuclide angiography (M UGA). Excellent correlation and close limits of agreement were noted betwee n SV measured by 3DE and EMF (r = 0.93) in dogs. In comparison with EMF-der ived SV, 3DE provided better correlation than the biplane method (r = 0.93 versus r = 0.61). Interobserver and intraobserver variabilities were compar able (r = 0.94 and r = 0.94, respectively). In a comparison of MUGA-derived EF values and those obtained by 3DE in human subjects, 3DE provided better correlation than the biplane method (r = 0.94 versus r = 0.85). Real-time 3DE accurately measures left ventricular volumes transthoracically over a w ide range of hemodynamic conditions in dogs and accurately determines EF in humans.