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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
06:34

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography

Published on: October 28, 2020

4.7K

Do we overestimate left ventricular ejection fraction by two-dimensional echocardiography in patients with left

Ali K Cabuk1, Gizem Cabuk2, Ahmet Sayin1

  • 1Department of Cardiology, Tepecik Training and Research Hospital, Izmir, Turkey.

Echocardiography (Mount Kisco, N.Y.)
|November 28, 2017
PubMed

Insights

Three-dimensional echocardiography improves left ventricular ejection fraction accuracy in patients with left bundle branch block (LBBB). Three-dimensional echocardiography is more reliable than 2D echocardiography for assessing LVEF in LBBB patients with high dyssynchrony index.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Left bundle branch block (LBBB) causes dyssynchrony in left ventricular contraction, impacting regional wall motion.
  • Two-dimensional (2D) echocardiography measurements of left ventricular ejection fraction (LVEF) may be unreliable in patients with LBBB.

Purpose of the Study:

  • To evaluate the role of the dyssynchrony index (SDI), measured by three-dimensional (3D) echocardiography, in accurately assessing LVEF and left ventricular volumes in patients with LBBB.
  • To compare the accuracy of 2D and 3D echocardiography in LBBB patients with varying degrees of dyssynchrony.

Main Methods:

  • A case-control study included 52 participants with LBBB and normal LVEF or nonischemic cardiomyopathy.
  • Left ventricular ejection fraction (LVEF) and volumes were assessed using both 2D (modified Simpson's rule) and 3D (four beats full volume analysis) echocardiography.
  • The impact of the dyssynchrony index (SDI) on the measurements was evaluated.

Main Results:

  • In patients with SDI ≥6%, LVEF measurements differed significantly between 2D and 3D echocardiography (46.00% vs 37.60%, P < .001).
  • No significant LVEF differences were observed between 2D and 3D echocardiography in patients with SDI < 6% (P = .193).
  • 2D echocardiography underestimated systolic volumes, particularly in patients with SDI ≥6%, while diastolic volumes showed no significant differences.

Conclusions:

  • In LBBB patients with high SDI (≥6%), 2D echocardiography overestimates LVEF and underestimates systolic volumes compared to 3D echocardiography.
  • 3D echocardiography provides more accurate assessments of LVEF and volumes in LBBB patients with significant dyssynchrony.
  • The dyssynchrony index is crucial for interpreting echocardiographic measurements in LBBB.
Abstract

Keywords:
B-mode echocardiographyleft bundle branch blockleft ventricular ejection fractionsystolic dyssynchrony indexthree-dimensional transthoracic echocardiography

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