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Visually estimated ejection fraction by two dimensional and triplane echocardiography is closely correlated with quantitative ejection fraction by real-time three dimensional echocardiography.

Shahgaldi K, Gudmundsson P, Manouras A, Brodin LA, Winter R - Cardiovasc Ultrasound (2009)

Bottom Line: The measurements were compared to quantitative RT3DE.There were an excellent correlation between eyeballing EF by 2D and TP vs 3DE (r = 0.91 and 0.95 respectively) without any significant bias (-0.5 +/- 3.7% and -0.2 +/- 2.9% respectively).There is an apparent trend towards a smaller variability using TP in comparison to 2D, this was however not statistically significant.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiology, Karolinska University Hospital Huddinge, Stockholm, Sweden. kambiz.shahgaldi@karolinska.se

ABSTRACT

Background: Visual assessment of left ventricular ejection fraction (LVEF) is often used in clinical routine despite general recommendations to use quantitative biplane Simpsons (BPS) measurements. Even thou quantitative methods are well validated and from many reasons preferable, the feasibility of visual assessment (eyeballing) is superior. There is to date only sparse data comparing visual EF assessment in comparison to quantitative methods available. The aim of this study was to compare visual EF assessment by two-dimensional echocardiography (2DE) and triplane echocardiography (TPE) using quantitative real-time three-dimensional echocardiography (RT3DE) as the reference method.

Methods: Thirty patients were enrolled in the study. Eyeballing EF was assessed using apical 4-and 2 chamber views and TP mode by two experienced readers blinded to all clinical data. The measurements were compared to quantitative RT3DE.

Results: There were an excellent correlation between eyeballing EF by 2D and TP vs 3DE (r = 0.91 and 0.95 respectively) without any significant bias (-0.5 +/- 3.7% and -0.2 +/- 2.9% respectively). Intraobserver variability was 3.8% for eyeballing 2DE, 3.2% for eyeballing TP and 2.3% for quantitative 3D-EF. Interobserver variability was 7.5% for eyeballing 2D and 8.4% for eyeballing TP.

Conclusion: Visual estimation of LVEF both using 2D and TP by an experienced reader correlates well with quantitative EF determined by RT3DE. There is an apparent trend towards a smaller variability using TP in comparison to 2D, this was however not statistically significant.

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Triplane echocardiography: 4 – 2 -and 3 chamber views are simultaneously displayed with 4-chamber as the reference view. Interplane angles are set at 60 degrees (A). A full volume acquisition of left ventricular during four cardiac cycles (B).
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Figure 1: Triplane echocardiography: 4 – 2 -and 3 chamber views are simultaneously displayed with 4-chamber as the reference view. Interplane angles are set at 60 degrees (A). A full volume acquisition of left ventricular during four cardiac cycles (B).

Mentions: When collecting the TP images of the LV, the apical 4-chamber view served as the reference image, and the two other planes were by default displayed with inter-plane angles set to 60 degrees. A figure showing the interposition of imaged planes was simultaneously displayed in a quad screen (figure 1A).


Visually estimated ejection fraction by two dimensional and triplane echocardiography is closely correlated with quantitative ejection fraction by real-time three dimensional echocardiography.

Shahgaldi K, Gudmundsson P, Manouras A, Brodin LA, Winter R - Cardiovasc Ultrasound (2009)

Triplane echocardiography: 4 – 2 -and 3 chamber views are simultaneously displayed with 4-chamber as the reference view. Interplane angles are set at 60 degrees (A). A full volume acquisition of left ventricular during four cardiac cycles (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2747837&req=5

Figure 1: Triplane echocardiography: 4 – 2 -and 3 chamber views are simultaneously displayed with 4-chamber as the reference view. Interplane angles are set at 60 degrees (A). A full volume acquisition of left ventricular during four cardiac cycles (B).
Mentions: When collecting the TP images of the LV, the apical 4-chamber view served as the reference image, and the two other planes were by default displayed with inter-plane angles set to 60 degrees. A figure showing the interposition of imaged planes was simultaneously displayed in a quad screen (figure 1A).

Bottom Line: The measurements were compared to quantitative RT3DE.There were an excellent correlation between eyeballing EF by 2D and TP vs 3DE (r = 0.91 and 0.95 respectively) without any significant bias (-0.5 +/- 3.7% and -0.2 +/- 2.9% respectively).There is an apparent trend towards a smaller variability using TP in comparison to 2D, this was however not statistically significant.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiology, Karolinska University Hospital Huddinge, Stockholm, Sweden. kambiz.shahgaldi@karolinska.se

ABSTRACT

Background: Visual assessment of left ventricular ejection fraction (LVEF) is often used in clinical routine despite general recommendations to use quantitative biplane Simpsons (BPS) measurements. Even thou quantitative methods are well validated and from many reasons preferable, the feasibility of visual assessment (eyeballing) is superior. There is to date only sparse data comparing visual EF assessment in comparison to quantitative methods available. The aim of this study was to compare visual EF assessment by two-dimensional echocardiography (2DE) and triplane echocardiography (TPE) using quantitative real-time three-dimensional echocardiography (RT3DE) as the reference method.

Methods: Thirty patients were enrolled in the study. Eyeballing EF was assessed using apical 4-and 2 chamber views and TP mode by two experienced readers blinded to all clinical data. The measurements were compared to quantitative RT3DE.

Results: There were an excellent correlation between eyeballing EF by 2D and TP vs 3DE (r = 0.91 and 0.95 respectively) without any significant bias (-0.5 +/- 3.7% and -0.2 +/- 2.9% respectively). Intraobserver variability was 3.8% for eyeballing 2DE, 3.2% for eyeballing TP and 2.3% for quantitative 3D-EF. Interobserver variability was 7.5% for eyeballing 2D and 8.4% for eyeballing TP.

Conclusion: Visual estimation of LVEF both using 2D and TP by an experienced reader correlates well with quantitative EF determined by RT3DE. There is an apparent trend towards a smaller variability using TP in comparison to 2D, this was however not statistically significant.

Show MeSH