Skip to main content

Determination of left ventricular mass by three-dimensional echocardiography: In vitro validation of a novel quantification method using multiple equi-angular rotational planes for rapid measurements


Measuring left ventricular mass by m-mode echocardiography or two-dimensional echocardiography is limited by the fact that calculations are based on assumptions, which describe left ventricular shape by simple geometric figures. The ability of three-dimensional echocardiography (3-DE) to accurately assess left ventricular mass has been shown previously, but 3-DE approaches to quantitative analysis of ventricular mass required multiple tomographic sectioning, manual tracing in various cut planes and were time consuming and laborious. We investigated the accuracy of a novel, rapid method of 3-DE mass quantification using multiple rotational planes in left ventricles in vitro. Methods: Three-dimensional data sets of 10 fixed pig hearts were obtained using a TomTec 3-DE system. For 3-DE mass calculations, a rotational axis in the center of the ventricle (apical–basal orientation) was defined and 3, 6 and 12 equi-angular rotational planes were created. The endocardial and epicardial contour of the left ventricle was traced in each cut plane and the volume of the corresponding myocardial wedge was automatically calculated. Mass was calculated by multiplying the resulting myocardial volume by the specific weight of myocardial tissue. The measurements were performed by two investigators blinded to the anatomic true mass and were analyzed for interobserver and intraobserver variability. Results: The anatomic left ventricular mass was measured 73–219 (168 ± 50) g. 3-DE mass ranged from 88–247 (207 ± 51) g (three planes), 84–250 (205 ± 52) g (six planes) and 86–241 (202 ± 50) g (12 planes) respectively. The correlation between 3-DE mass and anatomic LV mass measurements (r = 0.92) and between two observers (r = 0.97–0.98) was good. True mass was slightly overestimated by 3-DE measurement (SEE = 22–23 g). The intraobserver and interobserver variabilities were ≤4 and ≤7% respectively for all measurements. Conclusion: This new 3-DE method of left ventricular mass quantification with rotational approach provides accurate and reproducible measurements. In normal shaped left ventricles even three planes were sufficient to provide accurate mass measurements in vitro.

This is a preview of subscription content, access via your institution.


  1. 1.

    Koren MJ, Devereux RB, Casale PN, Savage DD, Laragh JH. Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med 1991; 114(5): 345–352.

    Google Scholar 

  2. 2.

    Gottdiener JS, Livengood SV, Meyer PS, Chase GA. Should echocardiography be performed to assess effects of antihypertensive therapy? Test–retest reliability of echocardiography for measurement of left ventricular mass and function. J Am Coll Cardiol 1995; 25(2): 424–430.

    Google Scholar 

  3. 3.

    Otterstad JE, Froeland G, St John SM, Holme I. Accuracy and reproducibility of biplane two-dimensional echocardiographic measurements of left ventricular dimensions and function. Eur Heart J 1997; 18(3): 507–513.

    Google Scholar 

  4. 4.

    Gopal AS, Keller AM, Shen Z, et al. Three-dimensional echocardiography: In vitro and in vivo validation of left ventricular mass and comparison with conventional echocardiographic methods. J Am Coll Cardiol 1994; 24(2): 504–513.

    Google Scholar 

  5. 5.

    Sapin PM, Gopal AS, Clarke GB, Smith MD, King DL. Three-dimensional echocardiography compared to two-dimensional echocardiography for measurement of left ventricular mass anatomic validation in an open chest canine model. Am J Hypertens 1996; 9(5): 467–474.

    Google Scholar 

  6. 6.

    Yao J, Cao QL, Masani N, et al. Three-dimensional echocardiographic estimation of infarct mass based on quantification of dysfunctional left ventricular mass. Circulation 1997; 96(5): 1660–1666.

    Google Scholar 

  7. 7.

    Gopal AS, Schnellbaecher MJ, Shen Z, et al. Freehand three-dimensional echocardiography for measurement of left ventricular mass: In vivo anatomic validation using explanted human hearts. J Am Coll Cardiol 1997; 30(3): 802–810.

    Google Scholar 

  8. 8.

    Chuang ML, Beaudin RA, Riley MF, et al. Three-dimensional echocardiographic measurement of left ventricular mass: Comparison with magnetic resonance imaging and two-dimensional echocardiographic determinations in man. Int J Card Imaging 2000; 16(5): 347–357.

    Google Scholar 

  9. 9.

    Kuhl HP, Franke A, Frielingsdorf J, et al. Determination of left ventricular mass and circumferential wall thickness by three-dimensional reconstruction: In vitro validation of a new method that uses a multiplane transesophageal transducer. J Am Soc Echocardiogr 1997; 10(2): 107–119.

    Google Scholar 

  10. 10.

    Krebs W, Klues HG, Steinert S, et al. Left ventricular volume calculations using a multiplanar transoesophageal echoprobe;in vitro validation and comparison with biplane angiography. Eur Heart J 1996; 17(8): 1279–1288.

    Google Scholar 

  11. 11.

    Danias PG, Chuang ML, Parker RA, et al. Relation between the number of image planes and the accuracy of three-dimensional echocardiography for measuring left ventricular volumes and ejection fraction. Am J Cardiol 1998; 82(11): 1431–1434, A9.

    Google Scholar 

  12. 12.

    Yao J, Kasprzak JD, Nosir YF, Frowijn R, Vletter WB, Roelandt JR. Appropriate 3-dimensional echocardiography data acquisition interval for left ventricular volume quantification: Implications for clinical application. J Am Soc Echocardiogr 1999; 12(12): 1053–1057.

    Google Scholar 

Download references

Author information



Rights and permissions

Reprints and Permissions

About this article

Cite this article

Teupe, C., Takeuchi, M., Yao, J. et al. Determination of left ventricular mass by three-dimensional echocardiography: In vitro validation of a novel quantification method using multiple equi-angular rotational planes for rapid measurements. Int J Cardiovasc Imaging 18, 161–167 (2002).

Download citation

  • imaging
  • left ventricular mass
  • three-dimensional echocardiography
  • ultrasound