Abstract
Recent guidelines regard three-dimensional echocardiography (DE) derived measurements of left ventricular (LV) volumes and ejection fraction (EF) as the method of choice. The feasibility of 3DE and agreement between 2DE and 3DE was examined. Our hypothesis was that a number of patients can only be examined with 2DE in a patient population admitted to a general hospital. Hospitalised patients referred for echocardiography by residents on call who found grounds to perform a pocket-sized ultrasound examination (PCU) were included. A subsequent 2DE and 3DE was planned. 3DE was considered unfeasible in the presence of irregular heart rhythm and poor quality imaging (included inability to hold breath). Agreement was evaluated with correlation and Bland–Altman analyses. Of 273 consecutive patients examined with 2DE, 202 (74 %) had satisfactory 3DE images for LV volume and EF measurements. Reasons for exclusion of 71 patients from the 3DE study included irregular heart rhythm in 58 patients and poor quality images in 13 patients. Median LV end-diastolic volume was 146 mL with 3DE and 161 mL with 2DE (p < 0.001). The respective values for LV end-systolic volume were 76 mL and 83 mL (p < 0.001), and for LVEF 48 % and 49 % (p = 0.061). Optimal 3DE assessment of LV volumes and EF could only be performed in 3/4 of patients. A significant overestimation of LV volumes was observed in terms of 2DE versus 3DE, whereas no such difference was found for LVEF.
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Otterstad JE, John Sutton MG, Froeland GS, Holme I, Skjaerpe T, Hall C (2002) Prognostic value of two-dimensional echocardiography and N-terminal proatrial natriuretic peptide following an acute myocardial infarction, Assessment of baseline values (2–7 days) and changes at 3 months in patients with a preserved systolic function. Eur Heart J 23(13):1011–1020
Wong M, Johnson G, Shabetai R, Hughes V, Bhat G, Lopez B, Cohn JN (1993) Echocardiographic variables as prognostic indicators and therapeutic monitors in chronic congestive heart failure Veterans. Affairs cooperative studies V-HeFT I and II. V-HeFT VA Cooperative Studies Group. Circulation 87(6):VI65–VI70
Stanton T, Leano R, Marwick TH (2009) Prediction of all-cause mortality from global longitudinal speckle strain: comparison with ejection fraction and wall motion scoring. Circ Cardiovasc Imaging 2(5):356–364. doi:10.1161/CIRCIMAGING.109.862334
Sjoli B, Grenne B, Smiseth OA, Edvardsen T, Brunvand H (2011) The advantage of global strain compared to left ventricular ejection fraction to predict outcome after acute myocardial infarction. Echocardiography 28(5):556–563. doi:10.1111/j.1540-8175.2011.01384.x
Otterstad JE, Froeland G, St John Sutton M, Holme I (1997) Accuracy and reproducibility of biplane two-dimensional echocardiographic measurements of left ventricular dimensions and function. Eur Heart J 18(3):507–513
Aune E, Baekkevar M, Rodevand O, Otterstad JE (2010) Reference values for left ventricular volumes with real-time 3-dimensional echocardiography. Scand Cardiovasc J 44(1):24–30. doi:10.3109/14017430903114446
Lang RM, Badano LP, Tsang W, Adams DH, Agricola E, Buck T, Faletra FF, Franke A, Hung J, de Isla LP, Kamp O, Kasprzak JD, Lancellotti P, Marwick TH, McCulloch ML, Monaghan MJ, Nihoyannopoulos P, Pandian NG, Pellikka PA, Pepi M, Roberson DA, Shernan SK, Shirali GS, Sugeng L, Ten Cate FJ, Vannan MA, Zamorano JL, Zoghbi WA (2012) EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography. Eur Heart J Cardiovasc Imaging 13(1):1–46. doi:10.1093/ehjci/jer316
Ruddox V, Stokke TM, Edvardsen T, Hjelmesaeth J, Aune E, Baekkevar M, Norum IB, Otterstad JE (2013) The diagnostic accuracy of pocket-size cardiac ultrasound performed by unselected residents with minimal training. The international journal of cardiovascular imaging. doi:10.1007/s10554-013-0278-7
Popescu BA, Andrade MJ, Badano LP, Fox KF, Flachskampf FA, Lancellotti P, Varga A, Sicari R, Evangelista A, Nihoyannopoulos P, Zamorano JL, European Association of E, Document R, Derumeaux G, Kasprzak JD, Roelandt JR (2009) European Association of Echocardiography recommendations for training, competence, and quality improvement in echocardiography. Eur J Echocardiogr 10(8):893–905. doi:10.1093/ejechocard/jep151
Hole T, Otterstad JE, John Sutton M, Froland G, Holme I, Skjaerpe T (2002) Differences between echocardiographic measurements of left ventricular dimensions and function by local investigators and a core laboratory in a 2-year follow-up study of patients with an acute myocardial infarction. Eur J Echocardiogr 3(4):263–270
Doppler flow and echocardiography in functional cardiac insufficiency: assessment of nisoldipine therapy. Results of the DEFIANT-II Study. The DEFIANT-II Research Group. (1997) European heart journal 18(1):31-40
Otterstad JE, Lubsen K, Parker A, Kirwan B, Plappert T, St John Sutton MG (1999) Left ventricular remodelling in post-myocardial infarction patients with left ventricular ejection fraction 40–50% versus 25–39%. Influence of nisoldipine treatment? An echocardiographic substudy from the DEFIANT II study. Scand Cardiovasc J 33(4):234–241
Otterstad JE, John Sutton M, Froland G, Skjaerpe T, Graving B, Holmes I (2001) Are changes in left ventricular volume as measured with the biplane Simpson’s method predominantly related to changes in its area or long axis in the prognostic evaluation of remodelling following a myocardial infarction? Eur J Echocardiogr 2(2):118–125
Marsan NA, Westenberg JJ, Roes SD, van Bommel RJ, Delgado V, van der Geest RJ, de Roos A, Klautz RJ, Reiber JC, Bax JJ (2011) Three-dimensional echocardiography for the preoperative assessment of patients with left ventricular aneurysm. Ann Thoracic Surg 91(1):113–121. doi:10.1016/j.athoracsur.2010.08.048
Muraru D, Badano LP, Piccoli G, Gianfagna P, Del Mestre L, Ermacora D, Proclemer A (2010) Validation of a novel automated border-detection algorithm for rapid and accurate quantitation of left ventricular volumes based on three-dimensional echocardiography. Eur J Echocardiogr 11(4):359–368. doi:10.1093/ejechocard/jep217
Greupner J, Zimmermann E, Grohmann A, Dubel HP, Althoff TF, Borges AC, Rutsch W, Schlattmann P, Hamm B, Dewey M (2012) Head-to-head comparison of left ventricular function assessment with 64-row computed tomography, biplane left cineventriculography, and both 2- and 3-dimensional transthoracic echocardiography: comparison with magnetic resonance imaging as the reference standard. J Am Coll Cardiol 59(21):1897–1907. doi:10.1016/j.jacc.2012.01.046
Mor-Avi V, Jenkins C, Kuhl HP, Nesser HJ, Marwick T, Franke A, Ebner C, Freed BH, Steringer-Mascherbauer R, Pollard H, Weinert L, Niel J, Sugeng L, Lang RM (2008) Real-time 3-dimensional echocardiographic quantification of left ventricular volumes: multicenter study for validation with magnetic resonance imaging and investigation of sources of error. JACC Cardiovasc Imaging 1(4):413–423. doi:10.1016/j.jcmg.2008.02.009
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The authors thank Matthew McGee, Morbid Obesity Center, Vestfold Hospital Trust, for proofreading the manuscript.
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Appendices
Appendix 1
Normal ranges for LV volumes and EF obtained with two- and three-dimensional echocardiography.
Appendix 2
Ranges for LV volumes and EF obtained with two- and three-dimensional echocardiography and MRI in four studies.
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Ruddox, V., Edvardsen, T., Bækkevar, M. et al. Measurements of left ventricular volumes and ejection fraction with three-dimensional echocardiography: feasibility and agreement compared to two-dimensional echocardiography. Int J Cardiovasc Imaging 30, 1325–1330 (2014). https://doi.org/10.1007/s10554-014-0478-9
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DOI: https://doi.org/10.1007/s10554-014-0478-9