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Updated: Jul 18, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Evaluation of left ventricular mass measured by 3D echocardiography using magnetic resonance imaging as gold standard
M Lenstrup1, J Kjaergaard, C L Petersen
1Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Denmark.
Insights
3D echocardiography accurately measures left ventricular mass (LVM), outperforming ECG methods. This finding is crucial for diagnosing and monitoring conditions like left ventricular hypertrophy (LVH) with improved accuracy.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Increased left ventricular mass (LVM) and left ventricular hypertrophy (LVH) are significant predictors of cardiovascular morbidity and mortality.
- Accurate and reproducible methods for LVM measurement are essential for diagnosis and treatment monitoring.
- Magnetic resonance imaging (MRI) is considered the gold standard for LVM assessment.
Purpose of the Study:
- To evaluate and compare the accuracy and reproducibility of different modalities for measuring LVM.
- To assess ECG (Sokolow-Lyon and Cornell formulae), 2D echocardiography, and 3D echocardiography against cardiac MRI as the gold standard.
- To determine the most reliable method for LVM assessment in patients without known LVH.
Main Methods:
- A study involving 34 subjects: 17 with myocardial infarction history, 7 with pulmonary hypertension, and 10 healthy controls.
- All participants underwent a standard 12-lead ECG, transthoracic 2D and 3D echocardiography, and cardiac MRI.
- Left ventricular mass (LVM) was measured using all three modalities and compared to MRI-derived LVM.
Main Results:
- ECG estimates of LVM showed poor correlation with MRI (r = 0.18 and 0.16, not significant).
- 2D echocardiography demonstrated a moderate correlation with MRI (r = 0.63, p<0.001).
- 3D echocardiography exhibited a strong correlation with MRI (r = 0.74, p<0.001), indicating high accuracy. All methods were reproducible without significant bias.
Conclusions:
- 3D echocardiography provides highly accurate LVM measurements compared to cardiac MRI.
- 2D echocardiography is also a useful tool for LVM calculation.
- ECG-based LVM estimations are inaccurate in a non-hypertrophic population, highlighting the superiority of echocardiographic methods.
Objective:
Increased left ventricular mass (LVM) and presence of left ventricular hypertrophy (LVH) are predictors of cardiovascular morbidity and mortality, but can be reversed with proper treatment of the underlying cause. Therefore accurate as well as reproducible methods for diagnosis and follow-up are needed. We evaluated different modalities by which to measure LVM in patients with no known LVH using magnetic resonance imaging (MRI) as the gold standard: ECG using the formulae proposed by Sokolow-Lyon and Cornell, 2D echocardiography and 3D echocardiography.
Methods:
34 subjects were included in the study; 17 had a history of myocardial infarction, 7 had pulmonary hypertension and 10 were healthy. All patients and controls had a standard 12-lead ECG, a transthoracic 2D and 3D echocardiographic study and a cardiac MRI.
Results:
ECG estimates of LVM correlated poorly with LVM by MRI (r = 0.18, NS and 0.16, NS for Sokolow-Lyon and Cornell, respectively), whereas a moderate correlation between 2D and 3D echocardiography and MRI was observed (r = 0.63, p<0.001 and r = 0.74, p<0.001, respectively). All methods were reproducible with no significant bias.
Conclusion:
LVM measured by 3D echocardiography is highly accurate compared to LVM measured by MRI. LVM calculated from 2D echocardiography also proved useful, whereas estimates of LVM by ECG are inaccurate in a non-hypertrophic population.
