Left ventricular volume and endocardial surface area by three-dimensional echocardiography: comparison with two-dimensional echocardiography and nuclear magnetic resonance imaging in normal subjects.
Gopal AS, Keller AM, Rigling R, King DL Jr, King DL.
Division of Cardiology, Columbia University, New York, New York 10032.
OBJECTIVES. We evaluated a three-dimensional echocardiographic method for ventricular volume and surface area determination that uses polyhedral surface reconstruction. Six to eight nonparallel, unequally spaced, nonintersecting short-axis planes were positioned with a line of intersection display to overcome limitations associated with two-dimensional echocardiography. BACKGROUND. Two-dimensional echocardiographic methods of ventricular volume and surface area determination are limited by assumptions about ventricular shape and image plane position. METHODS. Left ventricular end-diastolic and end-systolic volumes and endocardial surface areas determined by three-dimensional echocardiography and nuclear magnetic resonance (NMR) imaging were compared in 15 normal subjects (7 men, 8 women, aged 23 to 41 years, body surface area 1.38 to 2.17 m2). Ten of these subjects also underwent two-dimensional echocardiography; and end-diastolic and end-systolic volumes were determined by the apical biplane summation of discs method and compared with results of NMR imaging. RESULTS. Interobserver variability was 5% to 8% for three-dimensional echocardiography and 6% to 9% for NMR imaging. Both methods were in close agreement on end-diastolic volume (r = 0.92, SEE = 6.99 ml) and end-systolic volume (r = 0.81, SEE = 4.01 ml) and on end-diastolic surface area (r = 0.84, SEE = 8.25 cm2) and end-systolic surface area (r = 0.84, SEE = 4.89 cm2). Three-dimensional echocardiography and NMR imaging correlated significantly better for end-diastolic volume (r = 0.90, SEE = 7.0 ml) and end-systolic volume (r = 0.88, SEE = 3.1 ml) than did two-dimensional echocardiography and NMR imaging (r = 0.48, SEE = 20.5 ml for end-diastolic volume; r = 0.70, SEE = 5.6 ml for end-systolic volume). CONCLUSIONS. Three-dimensional echocardiography is an in vivo method of measuring left ventricular end-diastolic and end-systolic volumes and endocardial surface area with results comparable to those of NMR imaging. Additionally, three-dimensional echocardiography is superior to the two-dimensional echocardiographic apical biplane summation method because the technique eliminates geometric assumptions and image plane positioning error.
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PMID: 8509549 [PubMed - indexed for MEDLINE]