Limits...
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.

Show MeSH
Three-dimensional echocardiographic ejection fraction measurement. Automate delineations in diastole (A) and systole (B) resulting in EF of 55%.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2747837&req=5

Figure 2: Three-dimensional echocardiographic ejection fraction measurement. Automate delineations in diastole (A) and systole (B) resulting in EF of 55%.

Mentions: Analyses of the RT3DE data sets were performed using a commercially available semi-automated analysis tool, 4D auto LV volume quantification (4DLVQ, EchoPAC version 108.0.1, GE Vingmed Ultrasound, Horten, Norway). In end-diastole (ED) as well as end-systole (ES) a total of eighteen LV identification landmarks were made: two basal marks at the mitral annulus and one apical mark in the 4-chamber-, 2-chamber- and 3-chamber views respectively (figure 2). Respecting these landmarks, the software automatically delineated the endocardial border in a 3D-model from ED and ES phases. The LVEF is calculated by the software (ED-volume – ES-volume)/ED-volume × 100%. In cases where the automatic delineation of the endocardial border was considered suboptimal the borders could be adjusted manually, although no adjustments were made in this study.


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)

Three-dimensional echocardiographic ejection fraction measurement. Automate delineations in diastole (A) and systole (B) resulting in EF of 55%.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Three-dimensional echocardiographic ejection fraction measurement. Automate delineations in diastole (A) and systole (B) resulting in EF of 55%.
Mentions: Analyses of the RT3DE data sets were performed using a commercially available semi-automated analysis tool, 4D auto LV volume quantification (4DLVQ, EchoPAC version 108.0.1, GE Vingmed Ultrasound, Horten, Norway). In end-diastole (ED) as well as end-systole (ES) a total of eighteen LV identification landmarks were made: two basal marks at the mitral annulus and one apical mark in the 4-chamber-, 2-chamber- and 3-chamber views respectively (figure 2). Respecting these landmarks, the software automatically delineated the endocardial border in a 3D-model from ED and ES phases. The LVEF is calculated by the software (ED-volume – ES-volume)/ED-volume × 100%. In cases where the automatic delineation of the endocardial border was considered suboptimal the borders could be adjusted manually, although no adjustments were made in this study.

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