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Updated: Mar 27, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Relation between three-dimensional and two-dimensional echocardiography and biochemical analysis in patients with
Marcelo Luiz Campos Vieira1, Wercules Antônio Oliveira2, Alexandre Ferreira Cury2
1Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, Brazil.
Insights
Three-dimensional echocardiography (3D Echo) better correlates with cardiac biomarkers like brain natriuretic peptide and creatine kinase MB than two-dimensional echocardiography (2D Echo) for assessing left ventricular ejection fraction in ST-segment elevation acute myocardial infarction patients.
Area of Science:
- Cardiology
- Medical Imaging
- Biochemistry
Background:
- Prognosis in acute myocardial infarction (AMI) is influenced by myocardial injury markers and adaptive mechanisms.
- Accurate assessment of left ventricular ejection fraction (LVEF) is crucial for patient management post-AMI.
- Echocardiography, both 2D and 3D, plays a vital role in evaluating cardiac function.
Purpose of the Study:
- To evaluate the relationship between biochemical markers and echocardiographic findings in ST-segment elevation AMI patients.
- To compare the correlation of serum cardiac markers with LVEF derived from 3D Echo versus 2D Echo.
- To assess the utility of 3D Echo in conjunction with biochemical markers for evaluating myocardial injury.
Main Methods:
- A prospective study involving 23 patients with ST-segment elevation AMI undergoing primary percutaneous coronary intervention.
- Collected serum cardiac markers (creatine kinase MB, Troponin I, Myoglobin) and brain natriuretic peptide.
- Performed 2D Echo and 3D Echo to assess LVEF and ventricular dyssynchrony; statistical analysis included Pearson's correlation and Bland & Altman tests.
Main Results:
- 3D Echo LVEF showed a strong negative correlation with brain natriuretic peptide (r = -0.7427, p < 0.0001) and creatine kinase MB (r = -0.660, p = 0.001).
- 2D Echo LVEF demonstrated weaker negative correlations with brain natriuretic peptide (r = -0.5478, p = 0.001) and creatine kinase MB (r = -0.4800, p < 0.0277).
- No other significant associations were found between the tested parameters.
Conclusions:
- Three-dimensional echocardiography (3D Echo) demonstrates a superior correlation with serum creatine kinase MB and brain natriuretic peptide compared to 2D Echo for assessing LVEF.
- These findings suggest that 3D Echo may provide a more accurate assessment of myocardial injury in AMI patients when correlated with specific biomarkers.
- The study highlights the potential of advanced echocardiographic techniques in refining prognostic evaluations post-myocardial infarction.
Objective:
The prognosis of patients with acute myocardial infarction depends on multiple features that can demonstrate myocardial injury degree (such as serum markers of cardiac necrosis), and also on adaptive mechanisms relative to the acute event. The aim of the study was to assess the relation between biochemical and echocardiographic findings from three-dimensional echocardiographic (3D Echo) analysis and echocardiographic two-dimensional (2D Echo) left ventricular ejection fraction in patients with ST-segment elevation acute myocardial infarction, submitted to primary percutaneous treatment.
Methods:
A prospective study with 2D Echo and 3D Echo of 23 patients (17 males, mean age of 57 ± 13 years) with ST-segment elevation acute myocardial infarction, primarily percutaneously treated (stent). Serum cardiac markers (creatine kinase MB, Troponin I and Myoglobin) and serum brain natriuretic peptide were compared to echocardiographic parameters (volumes, left ventricular ejection fraction and ventricular dyssynchrony index). The statistical analysis was performed using Pearson's correlation coefficient, 95% CI, p < 0.05, linear regression equation and Bland & Altman test.
Results:
Pearson's correlation coefficient (r)relative to 3D left ventricular ejection fraction: 1- brain natriuretic peptide: r: - 0.7427, p < 0.0001; 2- creatine kinase MB: r: - 0.660, p = 0.001. Left ventricular ejection fraction 2D (r) : 1- brain natriuretic peptide: r: - 0.5478, p = 0.001; 2- creatine kinase MB: r: - 0.4800, p < 0.0277. Other associations were not significant.
Conclusions:
In this series, it was observed better correlation in regard to serum creatine kinase MB, brain natriuretic peptide and 3D Echo left ventricular ejection fraction, when compared to 2D Echo left ventricular ejection fraction.
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