Validation of real-time three-dimensional echocardiography for quantifying left ventricular volumes in the presence of a left ventricular aneurysm: in vitro and in vivo studies
Jian Xin Qin, MDa,
Michael Jones, MDb,
Takahiro Shiota, MD, PhD, FACCa,
Neil L. Greenberg, PhDa,
Hiroyuki Tsujino, MSa,
Michael S. Firstenberg, MDa,
Pankaj C. Gupta, BAa,
Arthur D. Zettsb,
Yong Xu, MDa,
Jing Ping Sun, MDa,
Lisa A. Cardon, RDCSa,
Jill A. Odabashiana,
Scott D. Flamm, MDa,
Richard D. White, MDa,
Julio A. Panza, MD, FACCc and
James D. Thomas, MD, FACCa
a Cardiovascular Imaging Center, Department of Cardiology, the Cleveland Clinic Foundation, Cleveland, OhioUSA
b Laboratory of Animal Surgery and Medicine, National Institutes of Health, Bethesda, MarylandUSA
c Cardiology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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Figure 1 After the apex of the outside balloon was excised (dashed line), a second balloon was inserted into it. When filled with water, this produced a phantom apical aneurysm.
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Figure 2 Left ventricular volume measurement by the apical six-plane method. Using as an axis of rotation the line from the apex to the center of the mitral valve annulus, the 3D Echotech system displayed the RT3DE images as six consecutive longitudinal planes rotated 30° from each adjacent plane. The LV cavity in each plane was traced manually, and the LV volume calculated by the multiplanar Simpson’s method. LV = left ventricle; RT3DE = real-time three-dimensional echocardiography.
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Figure 3 Linear regression between RT3DE, 2DE and actual volumes in the phantom study. RT3DE = real-time three-dimensional echocardiography; 2DE = two-dimensional echocardiography.
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Figure 4 Linear regression and analysis of agreement between RT3DE, 2DE and EM for LV SV in the animals without LV aneurysms. Open circles = data points from normal sheep; closed circles = data points from sheep with aortic regurgitation. 2DE = two-dimensional echocardiography; EM = electromagnetic flow meter; LV = left ventricle; RT3DE = real-time three-dimensional echocardiography; SV = stroke volume.
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Figure 5 Linear regression and analysis of agreement between RT3DE, 2DE and EM for LV SV in the animals with LV aneurysms. 2DE = two- dimensional echocardiography; EM = electromagnetic flow meter; LV = left ventricle; RT3DE = real-time three-dimensional echocardiography; SV = stroke volume.
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Figure 6 The correlations and agreements between RT3DE, 2DE and MRI for LV SV in patients with (open circles) and without (closed circles) LV aneurysms. 2DE = two-dimensional echocardiography; LV = left ventricle; MRI = magnetic resonance imaging; RT3DE = real-time three-dimensional echocardiography; SV = stroke volume.
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