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Left ventricular remodelling index (LVRI) in various pathophysiological conditions: a real-time three-dimensional echocardiographic study

Abstract

Background: Various studies have reported a close correlation between real-time three-dimensional echocardiography (RT3DE) and cine magnetic resonance imaging studies for the assessment of cardiac volumes and mass.

Objective: The aim of our study was to evaluate changes in left ventricular volumes and mass in subjects with different pathophysiological conditions. A ratio between left ventricular mass and end-diastolic volume (LVRI), detected by RT3DE, was used to describe various patterns of left ventricular remodelling.

Methods: RT3DE was performed to calculate left ventricular end-diastolic (LVEDV) and end-systolic volume (LVESV), ejection fraction (LVEF) and mass in 220 selected subjects. Of these, 152 were healthy volunteers, 19 top-level rowers, 23 patients with dilated cardiomyopathy and 26 patients with hypertrophic cardiomyopathy. Off-line analysis was performed by two independent operators by tracing manual endocardial and epicardial borders of the left ventricle through eight cutting planes. Inter- and intra-observer variability were calculated.

Results: Despite the increase in LV volume and mass in the rowers, LVRI remained unchanged compared with control subjects (p = 0.455), while significantly lower values were found patients with dilated cardiomyopathy (p<0.001) and significantly higher values in patients with hypertrophic cardiomyopathy (p<0.001). There was inter- and intra-observer variability.

Conclusion: The LVRI may serve as a simple and useful indicator of left ventricular adaptation to physiological and pathological conditions.

  • A, athletes
  • 3D, three-dimensional
  • DC, patients with dilated cardiomyopathy
  • ECG, electrocardiogram
  • HC, patients with hypertrophic cardiomyopathy
  • ICC, inter- and intra-class correlation coefficient
  • IQR, interquartile range
  • LVEDV, left ventricular end-diastolic volume
  • LVEF, left ventricular ejection fraction
  • LVESV, left ventricular end-systolic volume
  • LVM, left ventricular mass
  • LVRI, left ventricular remodelling index
  • RT3DE, real-time three-dimensional echocardiography
  • V, volunteers
  • 95% CI, 95% confidence interval
  • 3D echocardiography
  • LV mass
  • LV remodelling
  • LV volumes

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