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Updated: Jun 29, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Ventricular dyssynchrony index: comparison with two-dimensional and three-dimensional ejection fraction
Marcelo L C Vieira1, Alexandre F Cury, Naccarato Gustavo
1Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
Insights
Left ventricular electromechanical coupling (LV sync) assessed by 3D echocardiography (ECHO) strongly correlates with left ventricular ejection fraction (LVEF) measured by both 3D and 2D ECHO in patients with heart failure.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Left ventricular (LV) electromechanical coupling (synchrony) is crucial for assessing systolic performance.
- It is particularly important for guiding cardiac resynchronization therapy in advanced congestive heart failure (CHF).
Purpose of the Study:
- To compare LV synchrony analysis using real-time 3D echocardiography (ECHO) with left ventricular ejection fraction (LVEF) measurements.
- To evaluate the correlation between LV synchrony and LVEF obtained via 2D and 3D ECHO.
Main Methods:
- A prospective study included 92 individuals (60 normal, 32 with dilated cardiomyopathy).
- 3D ECHO was used to measure LVEF, volumes, and the dyssynchrony index (%DI) for 16 LV segments.
- 2D ECHO measured LVEF (Simpson's method) and LV systolic/diastolic volumes.
Main Results:
- The dyssynchrony index (%DI) ranged from 0.2900 to 28.1000.
- 3D LVEF ranged from 0.17 to 0.81, and 2D LVEF ranged from 0.3 to 0.69.
- A significant negative correlation was found between %DI and 3D LVEF (r=-0.7432, p<0.0001) and between %DI and 2D LVEF (r=-0.7012, p<0.0001).
Conclusions:
- A strong negative correlation exists between LV electromechanical synchrony and LVEF.
- Echocardiography (both 3D and 2D) effectively measures this relationship.
- These findings support the utility of 3D ECHO in assessing LV function and synchrony.
Background:
Left ventricular (LV) electromechanical coupling (synchrony) is important in the analysis of the systolic performance, especially for the indication of cardiac resynchronization therapy in patients with advanced CHF.
Objective:
To compare LV synchrony as analyzed by real-time three-dimensional (3D) echocardiography (ECHO) with LVEF measurements as obtained with 2D and 3D ECHO.
Methods:
Prospective study of 92 individuals (56 men, 47 +/- 10 years of age), of which 60 had normal heart structure (ECHO) and ECG (N group), and 32 had dilated cardiomyopathy (DCM group). Using 3D ECHO, LVEF, volumes and dyssynchrony index (%DI) for 16 LV segments were measured. Using 2D ECHO, LVEF (Simpson's method), and LV systolic and diastolic volumes were measured.
Statistical Analysis:
Pearson's correlation coefficient, 95% CI, linear regression model, Bland & Altman analysis, p<0.05.
Results:
%DI ranged from 0.2900 to 28.1000 (5.2014+/-6.3281), 3D LVEF ranged from 0.17 to 0.81 (0.52+/-0.17); and 2D LVEF ranged from 0.3 to 0.69 (0.49+/-0.11). The correlation between DI and 3D LVEF was (r): -0.7432, p<0.0001, CI: -0.8227 to -0.6350, the linear relation between DI (x) and 3D LVEF (y) was y = 19.8124 + (-27.9578) x, p<0.0001. The correlation between DI and 2D LVEF was (r): -0.7012, p<0.0001, CI: -0.7923 to -0.5797.
Conclusion:
In this case series, a good negative correlation was observed between LV electromechanical three-dimensional systolic coupling and LVEF as measured by echocardiography (3D and 2D).
