ECHOCARDIOGRAPHY
Reproducibility and accuracy of echocardiographic measurements of left ventricular parameters using real-time three-dimensional echocardiography
Carly Jenkins, BS,
Kristen Bricknell, BS,
Lizelle Hanekom, MD and
Thomas H. Marwick, MD, PhD, FACC*
University of Queensland, Brisbane, Australia
Manuscript received January 25, 2004;
revised manuscript received April 19, 2004,
accepted May 4, 2004.
* Reprint requests and correspondence: Dr. Thomas H. Marwick, University of Queensland Department of Medicine, Princess Alexandra Hospital, Ipswich Road, Brisbane, Q4102, Australia (Email: tmarwick{at}soms.uq.edu.au).
OBJECTIVES: We sought to determine whether assessment of left ventricular (LV) function with real-time (RT) three-dimensional echocardiography (3DE) could reduce the variation of sequential LV measurements and provide greater accuracy than two-dimensional echocardiography (2DE).
BACKGROUND: Real-time 3DE has become feasible as a standard clinical tool, but its accuracy for LV assessment has not been validated.
METHODS: Unselected patients (n = 50; 41 men; age, 64 ± 8 years) presenting for evaluation of LV function were studied with 2DE and RT-3DE. Test-retest variation was performed by a complete restudy by a separate sonographer within 1 h without alteration of hemodynamics or therapy. Magnetic resonance imaging (MRI) images were obtained during a breath-hold, and measurements were made off-line.
RESULTS: The test-retest variation showed similar measurements for volumes but wider scatter of LV mass measurements with M-mode and 2DE than 3DE. The average MRI end-diastolic volume was 172 ± 53 ml; LV volumes were underestimated by 2DE (mean difference, 54 ± 33; p < 0.01) but only slightly by RT-3DE (4 ± 29; p = 0.31). Similarly, end-systolic volume by MRI (91 ± 53 ml) was underestimated by 2DE (mean difference, 28 ± 28; p < 0.01) and by RT-3DE (mean difference, 3 ± 18; p = 0.23). Ejection fraction by MRI was similar by 2DE (p = 0.76) and RT-3DE (p = 0.74). Left ventricular mass (183 ± 50 g) was overestimated by M-mode (mean difference, 68 ± 86 g; p < 0.01) and 2DE (16 ± 57; p = 0.04) but not RT-3DE (0 ± 38 g; p = 0.94). There was good inter- and intra-observer correlation between RT-3DE by two sonographers for volumes, ejection fraction, and mass.
CONCLUSIONS: Real-time 3DE is a feasible approach to reduce test-retest variation of LV volume, ejection fraction, and mass measurements in follow-up LV assessment in daily practice.
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Abbreviations and Acronyms
| | EF = ejection fraction | | LV = left ventricle/ventricular | | LVEDV = left ventricular end-diastolic volume | | LVESV = left ventricular end-systolic volume | | MM = M-mode | | MRI = magnetic resonance imaging | | RT = real-time | | 2DE = two-dimensional echocardiography | | 3DE = three-dimensional echocardiography |
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|
 |
|

|
 |

|
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|
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|
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|
 |
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|
 |
|

|
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|
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|
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|

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|
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|
 |
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117(14):
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|
 |
|

|
 |

|
 |
 
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94(4):
440 - 445.
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[Full Text]
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|
 |
|

|
 |

|
 |
 
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March 1, 2008;
83(3):
372 - 373.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S.-C. Yap, R.-J. M. van Geuns, A. Nemes, F. J. Meijboom, J. S. McGhie, M. L. Geleijnse, M. L. Simoons, and J. W. Roos-Hesselink
Rapid and accurate measurement of LV mass by biplane real-time 3D echocardiography in patients with concentric LV hypertrophy: comparison to CMR
Eur J Echocardiogr,
March 1, 2008;
9(2):
255 - 260.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. I Burgess, C. Jenkins, J. Chan, and T. H Marwick
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October 1, 2007;
93(10):
1191 - 1196.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. N. Kirkpatrick, M. A. Vannan, J. Narula, and R. M. Lang
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J. Am. Coll. Cardiol.,
July 31, 2007;
50(5):
381 - 396.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
C. Jenkins, J. Chan, K. Bricknell, M. Strudwick, and T. H. Marwick
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June 1, 2007;
131(6):
1844 - 1851.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
H. Jaochim Nesser, L. Sugeng, C. Corsi, L. Weinert, J. Niel, C. Ebner, R. Steringer-Mascherbauer, F. Schmidt, G. Schummers, R. M Lang, et al.
Volumetric analysis of regional left ventricular function with real-time three-dimensional echocardiography: validation by magnetic resonance and clinical utility testing
Heart,
May 1, 2007;
93(5):
572 - 578.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. De Castro, S. Caselli, M. Maron, A. Pelliccia, E. Cavarretta, P. Maddukuri, D. Cartoni, E. Di Angelantonio, J. T Kuvin, A. R Patel, et al.
Left ventricular remodelling index (LVRI) in various pathophysiological conditions: a real-time three-dimensional echocardiographic study
Heart,
February 1, 2007;
93(2):
205 - 209.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. Cannesson, M. Tanabe, M. S. Suffoletto, D. M. McNamara, S. Madan, J. M. Lacomis, and J. Gorcsan III
A Novel Two-Dimensional Echocardiographic Image Analysis System Using Artificial Intelligence-Learned Pattern Recognition for Rapid Automated Ejection Fraction
J. Am. Coll. Cardiol.,
January 16, 2007;
49(2):
217 - 226.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S.-M. Park, K.-C. Kim, M.-J. Jeon, C.-K. Lee, D.-H. Kim, K.-S. Park, W.-H. Lee, and J. Kwan
Assessment of left ventricular asynchrony using volume--time curves of 16 segments by real-time 3 dimensional echocardiography: Comparison with tissue Doppler imaging
Eur J Heart Fail,
January 1, 2007;
9(1):
62 - 67.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. D. Thomas and Z. B. Popovic
Assessment of Left Ventricular Function by Cardiac Ultrasound
J. Am. Coll. Cardiol.,
November 21, 2006;
48(10):
2012 - 2025.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. M. Lang, V. Mor-Avi, L. Sugeng, P. S. Nieman, and D. J. Sahn
Three-Dimensional Echocardiography: The Benefits of the Additional Dimension
J. Am. Coll. Cardiol.,
November 21, 2006;
48(10):
2053 - 2069.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. C. Houck, J. E. Cooke, and E. A. Gill
Live 3D Echocardiography: A Replacement for Traditional 2D Echocardiography?
Am. J. Roentgenol.,
October 1, 2006;
187(4):
1092 - 1106.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. Sugeng, V. Mor-Avi, L. Weinert, J. Niel, C. Ebner, R. Steringer-Mascherbauer, F. Schmidt, C. Galuschky, G. Schummers, R. M. Lang, et al.
Quantitative Assessment of Left Ventricular Size and Function: Side-by-Side Comparison of Real-Time Three-Dimensional Echocardiography and Computed Tomography With Magnetic Resonance Reference
Circulation,
August 15, 2006;
114(7):
654 - 661.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E. G. Caiani, L. Sugeng, L. Weinert, A. Capderou, R. M. Lang, and P. Vaida
Objective evaluation of changes in left ventricular and atrial volumes during parabolic flight using real-time three-dimensional echocardiography
J Appl Physiol,
August 1, 2006;
101(2):
460 - 468.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. Fukuda, G. Saracino, Y. Matsumura, M. Daimon, H. Tran, N. L. Greenberg, T. Hozumi, J. Yoshikawa, J. D. Thomas, and T. Shiota
Three-Dimensional Geometry of the Tricuspid Annulus in Healthy Subjects and in Patients With Functional Tricuspid Regurgitation: A Real-Time, 3-Dimensional Echocardiographic Study
Circulation,
July 4, 2006;
114(1_suppl):
I-492 - I-498.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E. H. Y. Ie and R. Zietse
Evaluation of cardiac function in the dialysis patient--a primer for the non-expert
Nephrol. Dial. Transplant.,
June 1, 2006;
21(6):
1474 - 1481.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E G Caiani, C Corsi, L Sugeng, P MacEneaney, L Weinert, V Mor-Avi, and R M Lang
Improved quantification of left ventricular mass based on endocardial and epicardial surface detection with real time three dimensional echocardiography
Heart,
February 1, 2006;
92(2):
213 - 219.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. J Monaghan
Role of real time 3D echocardiography in evaluating the left ventricle
Heart,
January 1, 2006;
92(1):
131 - 136.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. De Simone, I. Wolf, S. Mottl-Link, B. W. Bottiger, H. Rauch, H.-P. Meinzer, and S. Hagl
Intraoperative assessment of right ventricular volume and function
Eur. J. Cardiothorac. Surg.,
June 1, 2005;
27(6):
988 - 993.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T. H. Marwick
Can we Justify the Cost of Echocardiography? Lessons from Outcomes Research
Eur J Echocardiogr,
June 1, 2005;
6(3):
155 - 163.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. E. Weyman
The year in echocardiography
J. Am. Coll. Cardiol.,
February 1, 2005;
45(3):
448 - 455.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. N. DeMaria, O. Ben-Yehuda, D. Berman, G. K. Feld, B. H. Greenberg, J. D. Knoke, K. U. Knowlton, W. Y.W. Lew, J. Narula, D. Sahn, et al.
Highlights of the year in JACC 2004
J. Am. Coll. Cardiol.,
January 4, 2005;
45(1):
137 - 153.
[Full Text]
[PDF]
|
 |
|
|