This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Siu, S. C. Articles by Picard, M. H. Search for Related Content PubMed PubMed Citation Articles by Siu, S. C. Articles by Picard, M. H.

Circulation, Vol 88, 1715-1723, Copyright © 1993 by American Heart Association

ARTICLES

Three-dimensional echocardiography. In vivo validation for left ventricular volume and function

SC Siu, JM Rivera, JL Guerrero, MD Handschumacher, JP Lethor, AE Weyman, RA Levine and MH Picard
Cardiac Unit, Massachusetts General Hospital, Boston 02114.

BACKGROUND. Current two-dimensional quantitative echocardiographic methods of volume assessment require image acquisition from standardized scanning planes. Left ventricular volume and ejection fraction are then calculated by assuming ventricular symmetry and geometry. These assumptions may not be valid in distorted ventricles. Three-dimensional echocardiography can quantify left ventricular volume without the limitations imposed by the assumptions of two-dimensional methods. We have developed a three-dimensional system that automatically integrates two-dimensional echocardiographic images and their positions in real time and calculates left ventricular volume directly from traced endocardial contours without geometric assumptions. METHODS AND RESULTS. To study the accuracy of this method in quantifying left ventricular volume and performance in vivo, a canine model was developed in which instantaneous left ventricular volume can be measured directly with an intracavitary balloon connected to an external column. Ten dogs were studied at 84 different cavity volumes (4 to 85 cm3) and in conditions of altered left ventricular shape produced by either coronary occlusion or right ventricular volume overload. To demonstrate clinical feasibility, 19 adult human subjects were then studied by this method for quantification of stroke volume. Left ventricular volume, stroke volume, and ejection fraction calculated by three-dimensional echocardiography correlated well with directly measured values (r = .98, .96, .96 for volume, stroke volume, and ejection fraction, respectively) and agreed closely with them (mean difference, -0.78 cm3, -0.60 cm3, -0.32%). In humans, there was a good correlation (r = .94, SEE = 4.29 cm3) and agreement (mean difference, - 0.98 +/- 4.2 cm3) between three-dimensional echocardiography and Doppler-derived stroke volumes. CONCLUSIONS. Three-dimensional echocardiography allows accurate assessment of left ventricular volume and systolic function.

This article has been cited by other articles:

				T. Geisler, H.C. Rost, P.S. Wild, and R. Zotz Freehand three-dimensional assessment of left ventricular volumes and ejection fraction with ultrasound contrast agent LK565 Eur J Echocardiogr, January 1, 2007; 8(1): 19 - 29. [Abstract] [Full Text] [PDF]

				R. Talens-Visconti, M. Rivera Otero, M. J. Sancho-Tello, F. G. de Burgos, L. Martinez-Dolz, B. Sevilla, V. Climent, R. Cortes, A. Salvador, F. Sogorb, et al. Left ventricular cavity area reflects N-terminal pro-brain natriuretic peptide plasma levels in heart failure Eur J Echocardiogr, January 1, 2006; 7(1): 45 - 52. [Abstract] [Full Text] [PDF]

				L Sugeng, L Weinert, and R M Lang Left ventricular assessment using real time three dimensional echocardiography Heart, November 1, 2003; 89(90003): iii29 - 36. [Full Text] [PDF]

				D. Gilon, E. G. Cape, M. D. Handschumacher, J.-K. Song, J. Solheim, M. VanAuker, M. E. E. King, and R. A. Levine Effect of three-dimensional valve shape on the hemodynamics of aortic stenosis: Three-dimensional echocardiographic stereolithography and patient studies J. Am. Coll. Cardiol., October 16, 2002; 40(8): 1479 - 1486. [Abstract] [Full Text] [PDF]

				J. X. Qin, M. Jones, T. Shiota, N. L. Greenberg, H. Tsujino, M. S. Firstenberg, P. C. Gupta, A. D. Zetts, Y. Xu, J. P. Sun, et al. 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 J. Am. Coll. Cardiol., September 1, 2000; 36(3): 900 - 907. [Abstract] [Full Text] [PDF]

				M. L. Chuang, M. G. Hibberd, C. J. Salton, R. A. Beaudin, M. F. Riley, R. A. Parker, P. S. Douglas, and W. J. Manning Importance of imaging method over imaging modality in noninvasive determination of left ventricular volumes and ejection fraction: Assessment by two- and three-dimensional echocardiography and magnetic resonance imaging J. Am. Coll. Cardiol., February 1, 2000; 35(2): 477 - 484. [Abstract] [Full Text] [PDF]

				R. De Simone, G. Glombitza, C. F. Vahl, J.o. Albers, H. P. Meinzer, and S. Hagl Three-dimensional color doppler: a clinical study in patients with mitral regurgitation J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1646 - 1654. [Abstract] [Full Text] [PDF]

				R. De Simone, G. Glombitza, C.F. Vahl, H.P. Meinzer, and S. Hagl Three-dimensional Doppler. Techniques and clinical applications Eur. Heart J., April 2, 1999; 20(8): 619 - 627. [Abstract] [PDF]

				R. De Simone, G. Glombitza, C.-F. Vahl, J. Albers, H.-P. Meinzer, and S. Hagl Assessment of mitral regurgitant jets by three-dimensional color Doppler Ann. Thorac. Surg., February 1, 1999; 67(2): 494 - 499. [Abstract] [Full Text] [PDF]

				R. De Simone, G. Glombitza, C.-F. Vahl, J. Albers, H.-P. Meinzer, and S. Hagl Three-dimensional color Doppler for assessing mitral regurgitation during valvuloplasty Eur. J. Cardiothorac. Surg., February 1, 1999; 15(2): 127 - 133. [Abstract] [Full Text] [PDF]

				C. S. Breburda, B. P. Griffin, M. Pu, L. Rodriguez, D. M. Cosgrove III, and J. D. Thomas Three-dimensional echocardiographic planimetry of maximal regurgitant orifice area in myxomatous mitral regurgitation: intraoperative comparison with proximal flow convergence J. Am. Coll. Cardiol., August 1, 1998; 32(2): 432 - 437. [Abstract] [Full Text] [PDF]

				T. Buck, P. Hunold, K. U. Wentz, W. Tkalec, H. J. Nesser, and R. Erbel Tomographic Three-dimensional Echocardiographic Determination of Chamber Size and Systolic Function in Patients With Left Ventricular Aneurysm : Comparison to Magnetic Resonance Imaging, Cineventriculography, and Two-dimensional Echocardiography Circulation, December 16, 1997; 96(12): 4286 - 4297. [Abstract] [Full Text]

				D. Gilon, E. G. Cape, M. D. Handschumacher, L. Jiang, C. Sears, J. Solheim, E. Morris, J. T. Strobel, S. M. Miller-Jones, A. E. Weyman, et al. Insights From Three-dimensional Echocardiographic Laser Stereolithography: Effect of Leaflet Funnel Geometry on the Coefficient of Orifice Contraction, Pressure Loss, and the Gorlin Formula in Mitral Stenosis Circulation, August 1, 1996; 94(3): 452 - 459. [Abstract] [Full Text]

				Y. F.M. Nosir, P. M. Fioretti, W. B. Vletter, E. Boersma, A. Salustri, J. T. Postma, A. E.M. Reijs, F. J. Ten Cate, and J. R.T.C. Roelandt Accurate Measurement of Left Ventricular Ejection Fraction by Three-dimensional Echocardiography: A Comparison With Radionuclide Angiography Circulation, August 1, 1996; 94(3): 460 - 466. [Abstract] [Full Text]