3D and 2D left ventricular systolic function imaging-- from ejection fraction to deformation. Cardiac...

Area of Science:

• Cardiovascular Imaging
• Echocardiography
• Cardiac Mechanics

Background:

• 3D echocardiography offers advanced capabilities for assessing left ventricular systolic function.
• Traditional 2D echocardiography has limitations in comprehensive functional analysis.
• Evaluating the effectiveness of cardiac resynchronization therapy (CRT) requires precise functional assessment.

Purpose of the Study:

• To evaluate the utility of 3D echocardiography in assessing left ventricular systolic function.
• To test the performance of 3D regional measurements, specifically area strain.
• To prospectively compare 3D echocardiography with 2D echocardiography in predicting CRT response.

Main Methods:

• Retrospective analysis of 42 subjects (23 heart failure patients, 19 controls) using 2D-Simpson's, 3D-triplane, and automated volumetric methods.
• Prospective assessment of 24 CRT patients before and after 6 months of therapy.
• Defined CRT response by a 15% reduction in left ventricular end-systolic volume (ESV).

Main Results:

• 3D volumetric method was significantly faster for ejection fraction assessment (P < 0.001).
• Global peak longitudinal strain correlated with QRS width in heart failure patients (r = 0.47, P = 0.023).
• 3D strain parameters demonstrated good accuracy in selecting CRT candidates and predicting response, with high sensitivity and specificity.

Conclusions:

• 3D echocardiography is a fast, user-friendly tool for assessing left ventricular ejection fraction in various patient groups.
• 3D strain analysis shows promise for improving the selection of CRT candidates and assessing treatment response.
• 3D echocardiography algorithms accurately identified CRT responders and non-responders, showing high agreement with 2D methods.