Comparison between 2D and 3D echocardiography in the evaluation of reverse remodeling after CRT

Echocardiography is a useful method for screening and assessing response to cardiac resynchronization therapy (CRT). 3D echocardiography has already established its role in the evaluation of ventricular volumes and ejection fraction (LVEF) with excellent correlation of results when compared with MRI.

To compare the evaluation of ventricular volumes (LVDV, LVSV), LVEF, and LV mass before and after CRT by 2D echocardiography and three-dimensional echocardiography.

We evaluated 24 patients with heart failure (HF), functional class (FC) III or IV (NYHA), sinus rhythm QRS ≥ 120 ms, during an optimized therapy for HF undergoing CRT. We conducted electrocardiogram (ECG), clinical evaluation, 2D and 3D echocardiography before, three and six months after CRT. The comparison between the techniques was performed using Pearson's correlation (r).

At baseline, the correlation between methods was 0.96 for evaluation of LVDV, 0.95 for evaluation of LVSV, 0.87 for LVEF and 0.72 for LV mass. After three months of CRT, the correlation between methods for analysis of LVDV was 0.96, 0.95 for LVSV, 0.95 for LVEF, and 0.77 for LV mass. After six months of CRT, the correlation between 2D and 3D echocardiography for analysis of LVDV was 0.98, 0.91 for LVSV, 0.96 for LVEF, and 0.85 for LV mass.

This study reported was a reduction of LVDV, LVSV, besides improvement in LVEF after CRT. There was an excellent correlation between the 2D and 3D echocardiography for evaluation of ventricular volumes and LVEF, and a good correlation between methods for evaluation of left ventricular mass before and after CRT.