Original article
Left Ventricular Structure and Function for Postmyocardial Infarction and Heart Failure Risk Stratification by Three-dimensional Echocardiography

https://doi.org/10.1016/j.echo.2007.01.014Get rights and content

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Patients

In all, 55 patients (49 male; mean age 62.6 years) with: (1) prior MI (n = 49) or radiologic evidence of CHF (n = 6); and (2) EF less than or equal to 40% by routine methods (2DECHO, 42 patients; MUGA, 8 patients; CATH, 5 patients) were imaged by quantitative 2DECHO (Q2DECHO), 3DECHO, and CMR within 24 hours. The same sonographer performed duplicate Q2DECHO and 3DECHO examinations in 10 patients in the same session after requesting the patient to stand up and assume the left lateral decubitus

Comparability of FH3DECHO and RT3DECHO

All patients had abnormal ventricles with a mean CMR EF of 40.3 ± 15.9%. The mean differences among LV EDV, ESV, and EF by FH3DECHO and CMR were 8.7 mL, 5.4 mL, and 0.5%; the corresponding differences between RT3DECHO and CMR were 8.7 mL, 9.1 mL, and 1.4%. t Test analysis of the mean differences and the ANOVA of the regressions did not reveal differences between FH3DECHO and RT3DECHO. Because FH3DECHO and RT3DECHO perform comparably when compared with CMR, results in patients studied with both

Discussion

Our study shows that methods such as 2DECHO, CATH, and MUGA are unreliable for risk stratification by EF post-MI when compared with CMR, thus, proving our primary hypothesis. Risk stratification by 3DECHO achieves significantly better results. Reduced test-retest variability of 3DECHO compared with Q2DECHO establishes its use for serial monitoring. The optimal technique for measurement of LV volumes after MI has been studied by Chan et al17 using RT3DECHO, single photon emission CT (SPECT), and

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References (41)

  • M.L. Chuang et al.

    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

    (2000)
  • M.G. Hibberd et al.

    Accuracy of three-dimensional echocardiography with unrestricted selection of imaging planes for measurement of left ventricular volumes and ejection fraction

    Am Heart J

    (2000)
  • M.A. Schmidt et al.

    Real-time three-dimensional echocardiography for the measurement of left ventricular volumes

    Am J Cardiol

    (1999)
  • H.F. Mannaerts et al.

    Quantification of left ventricular volumes and ejection fraction using freehand transthoracic three-dimensional echocardiography: comparison with magnetic resonance imaging

    J Am Soc Echocardiogr

    (2003)
  • J.X. Qin 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

    (2000)
  • D. Mele et al.

    Three-dimensional echocardiographic reconstruction: description and applications of a simplified technique for quantitative assessment of left ventricular size and function

    Am J Cardiol

    (1998)
  • S. Takuma et al.

    Assessment of left ventricular function by real-time 3-dimensional echocardiography compared with conventional noninvasive studies

    J Am Soc Echocardiogr

    (2001)
  • K. Arai et al.

    Accuracy of measurement of left ventricular volume and ejection fraction by new real-time three dimensional echocardiography in patients with wall motion abnormalities secondary to myocardial infarction

    Am J Cardiol

    (2004)
  • J. Kawai et al.

    Rapid freehand scanning three-dimensional echocardiography: accurate measurement of left ventricular volumes and ejection fraction compared with quantitative gated scintigraphy

    J Am Soc Echocardiogr

    (2003)
  • M.A. Schmidt et al.

    Anatomic validation of a novel method for left ventricular volume and mass measurements with use of real-time 3-dimensional echocardiography

    J Am Soc Echocardiogr

    (2001)

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    Copyright © 2007 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.