A New Method for Echocardiographic Computerized Three-dimensional Reconstruction of Left Ventricular Endocardial Surface: In Vitro Accuracy and Clinical Repeatability of Volumes

doi:10.1016/S0894-7317(14)80079-5

Journal of the American Society of Echocardiography

Volume 7, Issue 6, November–December 1994, Pages 571-581

https://doi.org/10.1016/S0894-7317(14)80079-5 Get rights and content

This study evaluates the in vitro accuracy and clinical repeatability of volumes derived by a new algorithm for three-dimensional reconstruction of cavity surfaces based on echocardiographic apical images obtained by probe rotation. The accuracy of the method was tested in latex phantoms (true volumes, 32 to 349 cm³) with (n = 9) or without (n = 9) rotational symmetry around the midcavitary long axis. Repeatability of left ventricular volumes was assessed in subjects without (n = 5) or with (n = 10) myocardial disease. Estimated phantom volumes obtained from four (three) imaging planes were close to true volumes with a mean difference ± SD of 0 ± 2 (2 ± 3) cm³ in symmetric and 1 ± 3 (4 ± 4) cm³ in asymmetric objects. Biplane and single-plane volume estimates were less accurate. Interobserver and intraobserver repeatability of three-dimensional left ventricular volumes was good for analysis (coefficients of variation: 3.5% to 6.2%) and was lower for recording (coefficients of variation: 7.4% to 10.9%). Hence the present algorithm reproduces volumes of symmetric and deformed in vitro objects accurately over a wide range of size and shape, and it produces repeatable left ventricular volumes in the clinical situation.

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Cited by (46)

Efficient Quantification of the Left Ventricular Volume Using 3-Dimensional Echocardiography: The Minimal Number of Equiangular Long-axis Images for Accurate Quantification of the Left Ventricular Volume
2007, Journal of the American Society of Echocardiography
Citation Excerpt :
The volume range of these studies was 3 times smaller than in our study, which explains the slightly better results. In the two in vitro studies for which this was not the case static balloons and latex models were used.33,34 Unfortunately, the study of Krebs et al35 can not be discussed because no comparable data were presented.
For quantification of the left ventricular volume from 3-dimensional echocardiograms a number of cross-sectional images are used. The goal of this study was to determine the minimum number of long-axis images necessary for accurate quantification of the left ventricular volume. A strong correlation was observed between volumes obtained from magnetic resonance imaging and 3-dimensional echocardiography using 16 equiangular images (r = 0.99; y = 0.95x + 3.3 mL; standard error of the estimate = 7.0 mL; N = 30). Comparison of these results with random subsets showed a significant difference for volumes obtained with 4 and 2 equiangular images (P < .005). However, when the subsets were selected to target the eccentric region of the endocardial border this was only the case for subsets of two images (P < .001). This study demonstrates that accurate left ventricular volume quantification can be performed with as little as 8 equiangular long-axis images. By selecting the correctly oriented image set, this number can even be brought down to 4, which will further reduce the analysis time.
Real-time Simultaneous Triplane Contrast Echocardiography Gives Rapid, Accurate, and Reproducible Assessment of Left Ventricular Volumes and Ejection Fraction: A Comparison with Magnetic Resonance Imaging
2006, Journal of the American Society of Echocardiography
We sought to compare the feasibility, accuracy, and reproducibility of simultaneous triplane echocardiography for measurements of left ventricular (LV) volumes and ejection fraction (EF) with reference to magnetic resonance imaging (MRI).
Digital echocardiography recordings of apical LV views with and without intravenous contrast were collected from 53 consecutive patients with conventional 2-dimensional (2D) imaging and with simultaneous triplane imaging. MRI of multiple LV short-axis sections was performed with a 1.5-T scanner. Endocardial borders were manually traced, and LV volumes and EF from 2D biplane echocardiography and MRI were calculated by method of disks. On triplane data, a triangular mesh was constructed by 3-dimensional interpolation and volumes calculated by the divergence theorem.
Triplane image acquisition was less time-consuming than 2D biplane. Precontrast feasibility was 72% for triplane and 82% for 2D biplane images, increasing to 98% and 100% with contrast, respectively. Bland-Altman analysis demonstrated LV volume underestimation by echocardiography versus MRI, which was significantly reduced by contrast and triplane imaging. The 95% limits of agreement for EF between echocardiography and MRI narrowed using triplane compared with 2D biplane (precontrast −12.5 to 6.7% vs −17.2 to 9.9%, and with contrast −7.1 to 5.8% vs −9.4 to 6.4%, respectively). At intraobserver and interobserver analysis of 20 patients, limits of agreement for EF narrowed with contrast triplane compared with 2D biplane.
Simultaneous LV triplane imaging is feasible with simple and rapid image acquisition and volume analysis, and with contrast enhancement it gives accurate and reproducible LV EF measurements compared with MRI.
Left atrial size: Renewed interest in an old echocardiographic measurement
2004, American Heart Journal
Effects of revascularisation and contractile reserve on left ventricular remodelling in patients with impaired left ventricular function
2004, International Journal of Cardiology
Objective: We sought to define the influence of revascularisation and contractile reserve on left ventricular (LV) remodelling in patients with LV dysfunction after myocardial infarction. Revascularisation of viable myocardium is associated with improved regional function, but the effect on remodelling is undefined. Methods: We studied 70 patients with coronary artery disease and LV dysfunction, 31 of whom underwent revascularisation. A standard dobutamine stress echocardiogram (DbE) was carried out. All patients underwent standard medical treatment; the decision to revascularise was made clinically, independent of this study. LV volumes and ejection fraction were measured by 3D echocardiography at baseline and after an average of 40 weeks. Results: There was no significant difference in baseline ejection fraction or volumes between patients who underwent revascularisation and the remainder. Compared to medically treated patients, revascularised patients had significant improvements in ejection fraction and end-systolic volume in follow-up. The impact of baseline variables on remodelling was assessed by dividing patients into tertiles of LV ejection fraction and volumes. Revascularised patients in the lowest tertile of ejection fraction at baseline (<38%) had a significant improvement in end-systolic volume and ejection fraction, larger than obtained in medically treated patients with low ejection fraction. Revascularised patients with an ejection fraction >38% did not show significant improvement in volumes compared to baseline. Revascularised patients in the largest tertiles of end-systolic (>88 ml) or end-diastolic volume (>149 ml) at baseline had a significant improvement in end-systolic volume. Conclusion: Remodeling appears to occur independent of the presence of regional contractile reserve but does correlate with the volume response to low-dose dobutamine.
Validation of a volumic reconstruction in 4-D echocardiography and gated spect using a dynamic cardiac phantom
2003, Ultrasound in Medicine and Biology
A dynamic cardiac phantom was used as a reference to compare the volumes reconstructed with 4-D echocardiography and gated single-photon emission computed tomography (SPECT). 4-D echocardiography used a new prototype of rotating scan head to acquire ultrasound (US) images during a cardiac cycle, associated with a new protocol (left ventricular 4-D or LV 4-D) to reconstruct the volume deformations of the heart as a function of time. Gated SPECT data were acquired with a standard single-head gamma camera, and the reconstructions were carried out using the Mirage software released by Segami. The influences of different LV 4-D parameters were tested and analyzed. End-diastolic volume, end-systolic volume, and ejection fraction were measured using both LV 4-D and gated SPECT. Results obtained showed a straight correlation between the two examinations. The agreement confirmed the relevance of the comparisons. This study is an initial step before conducting clinical trials to exhaustively compare the two modalities. (E-mail: [email protected])
Correlates of subclinical left ventricular dysfunction in ESRD
2003, American Journal of Kidney Diseases
Citation Excerpt :
The percentage of diameter change for FMD and exogenous nitrate was calculated in relation to the respective resting scan. LV volumes were measured by means of a previously validated method of three-dimensional reconstruction from two-dimensional images.25 End-systolic and end-diastolic endocardial contours were traced off-line from digitally stored resting images; end-systolic volume (ESV) was measured on the frame immediately after isovolumic contraction, and end-diastolic volume (EDV) was measured as the frame with the largest cardiac blood volume.
Abnormalities of the left ventricle are common in patients with end-stage renal disease (ESRD) both before and after the start of renal replacement therapy. The purpose of this study is to identify possible causes of subclinical left ventricular (LV) dysfunction in patients with ESRD. In particular, we sought to determine whether the presence of ESRD was itself associated with dysfunction independent of LV hypertrophy and coronary artery disease.
Assessment of cardiovascular risk factors and dialysis adequacy was completed in 145 unselected patients with ESRD who were recruited from the renal dialysis unit and compared with age- and sex-matched controls. Among the 68 patients with ESRD who had undergone a dobutamine stress echocardiogram with normal findings, regional cardiac function was quantified by myocardial Doppler velocity, LV volumes and mass were measured using three-dimensional echocardiography, and vascular function was assessed using brachial artery reactivity (BAR).
LV diastolic velocity was impaired in patients with ESRD, but there was no significant difference in systolic velocity compared with control patients of similar age. Age, diabetes mellitus, hypertension, and LV mass were independent predictors of diastolic velocity (model R² = 0.45; P < 0.001), whereas age and risk factor number were predictors of systolic velocity (model R² = 0.19; P = 0.002). Increasing risk factor number had no significant relationship with LV mass or volume. There was no detected association between BAR and incremental risk factors (P = 0.51).
Subclinical LV dysfunction occurs in patients with ESRD, but is evidenced as abnormal myocardial diastolic, rather than systolic, function. Correlates of abnormal function are age, diabetes mellitus, hypertension, and LV mass, rather than ESRD alone, dialysis adequacy, or abnormal endothelial function.

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: Supported by grants from the Norwegian Council on Cardiovascular Diseases (Oslo, Norway) and Norwegian Technical Research Council (NTNF).

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A New Method for Echocardiographic Computerized Three-dimensional Reconstruction of Left Ventricular Endocardial Surface: In Vitro Accuracy and Clinical Repeatability of Volumes

J Am Coll Cardiol

Am Heart J

Am J Cardiol

J Am Coll Cardiol

J Am Coll Cardiol

Ultrasound Med Biol

Am Heart J

J Am Coll Cardiol

J Am Soc Echocardiogr

J Am Coll Cardiol

J Am Coll Cardiol

Left ventricular volume from paired biplane two-dimensional echocardiography

Circulation

Three dimensional reconstruction of the left ventricle from multiple cross sectional echocardiograms: value for measuring left ventricular volume

Br Heart J