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Updated: May 8, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Fast measurement of left ventricular mass with real-time three-dimensional echocardiography: comparison with magnetic
Victor Mor-Avi1, Lissa Sugeng, Lynn Weinert
1Noninvasive Cardiac Imaging Laboratory, University of Chicago, Chicago, Ill 60637, USA. vmoravi@medicine.bsd.uchicago.edu
Insights
Real-time 3D echocardiography offers more accurate left ventricular (LV) mass measurements than 2D methods. This advanced technique improves correlation with cardiac MR and reduces measurement variability.
Area of Science:
- Cardiovascular Imaging
- Echocardiography
- Medical Diagnostics
Background:
- Left ventricular (LV) mass is a critical predictor of cardiovascular morbidity and mortality, particularly in hypertensive patients.
- Traditional 2D echocardiography faces limitations in accurately measuring LV mass due to difficulties in obtaining optimal apical views.
- Cardiac magnetic resonance (CMR) serves as a benchmark for LV mass assessment.
Purpose of the Study:
- To evaluate the accuracy of real-time 3D (RT3D) echocardiography for LV mass measurement compared to 2D echocardiography and CMR.
- To assess the impact of RT3D imaging on reducing measurement variability.
Main Methods:
- Retrospective analysis of echocardiographic and CMR data from 21 patients.
- Acquisition of 2D and RT3D echocardiographic datasets.
- Offline selection of non-foreshortened apical views from RT3D datasets for LV mass calculation using the biplane method of disks.
- Comparison of LV mass measurements between 2D echo, RT3D echo, and CMR.
Main Results:
- RT3D echocardiography yielded larger LV long-axis dimensions and LV mass measurements that correlated better with CMR (r=0.90) than 2D echocardiography (r=0.79).
- 2D echocardiography significantly underestimated LV mass (39% bias), while RT3D showed minimal bias (3%).
- RT3D significantly reduced interobserver (37% to 7%) and intraobserver (19% to 8%) variability compared to 2D methods.
Conclusions:
- Real-time 3D echocardiography enables accurate and reliable measurement of left ventricular mass.
- RT3D imaging overcomes the limitations of 2D echocardiography in LV mass assessment.
- The improved accuracy and reduced variability of RT3D make it a valuable tool for cardiovascular assessment.
Background:
Left ventricular (LV) mass is an important predictor of morbidity and mortality, especially in patients with systemic hypertension. However, the accuracy of 2D echocardiographic LV mass measurements is limited because acquiring anatomically correct apical views is often difficult. We tested the hypothesis that LV mass could be measured more accurately from real-time 3D (RT3D) data sets, which allow offline selection of nonforeshortened apical views, by comparing 2D and RT3D measurements against cardiac MR (CMR) measurements.
Methods And Results:
Echocardiographic imaging was performed (Philips 7500) in 21 patients referred for CMR imaging (1.5 T, GE). Apical 2- and 4-chamber views and RT3D data sets were acquired and analyzed by 2 independent observers. The RT3D data sets were used to select nonforeshortened apical 2- and 4-chamber views (3DQ-QLAB, Philips). In both 2D and RT3D images, LV long axis was measured; endocardial and epicardial boundaries were traced, and mass was calculated by use of the biplane method of disks. CMR LV mass values were obtained through standard techniques (MASS Analysis, GE). The RT3D data resulted in significantly larger LV long-axis dimensions and measurements of LV mass that correlated with CMR better (r=0.90) than 2D (r=0.79). The 2D technique underestimated LV mass (bias, 39%), whereas RT3D measurements showed only minimal bias (3%). The 95% limits of agreement were significantly wider for 2D (52%) than RT3D (28%). Additionally, the RT3D technique reduced the interobserver variability (37% to 7%) and intraobserver variability (19% to 8%).
Conclusions:
RT3D imaging provides the basis for accurate and reliable measurement of LV mass.
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