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Left ventricular remodelling index (LVRI) in various pathophysiological conditions: a real-time three-dimensional echocardiographic study
  1. Stefano De Castro1,
  2. Stefano Caselli1,
  3. Martin Maron2,
  4. Antonio Pelliccia3,
  5. Elena Cavarretta1,
  6. Prasad Maddukuri2,
  7. Domenico Cartoni1,
  8. Emanuele Di Angelantonio1,
  9. Jeffrey T Kuvin2,
  10. Ayan R Patel2,
  11. Natesa G Pandian2
  1. 1Department of Cardiovascular, Respiratory and Morphological Sciences, “La Sapienza”, University of Rome, Italy
  2. 2Tufts-New England Medical Center, Tufts University, Boston, MA, USA
  3. 3National Institute of Sports Medicine, Rome, Italy
  1. Correspondence to:
    Dr Stefano De Castro
    Department of Cardiovascular, Respiratory and Morphological Sciences, “La Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; stefano.decastro{at}


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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  • Published Online First 16 August 2006

  • Competing interests: None.