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LEFT VENTRICULAR EJECTION FRACTION: COMPARISON BETWEEN TRUE VOLUME-BASED MEASUREMENTS AND AREA-BASED ESTIMATES.

Dawei Liu1, Isabelle Peck1,2, Shusil Dangi1

  • 1Chester F. Carlson Center for Imaging Science, Rochester Institute of Technology, Rochester, NY, USA.

Proceedings. IEEE Western New York Image and Signal Processing Workshop
|June 25, 2019
PubMed
Summary

Cardiologists often underestimate left ventricular ejection fraction (LVEF) by using 2D area changes. This study confirms volume-based measurements are more accurate for assessing cardiac function.

Keywords:
3D reconstructionechocardiographyleft ventricular ejection fraction

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Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Left ventricular ejection fraction (LVEF) is a key metric for cardiac health and treatment decisions.
  • Echocardiography (ultrasound) is the standard non-invasive method for LVEF assessment.
  • Current clinical practice often relies on 2D image analysis for LVEF estimation.

Purpose of the Study:

  • To investigate the discrepancy between area-based and volume-based LVEF calculations.
  • To validate whether 2D area estimations underestimate true LVEF.
  • To emphasize the importance of volumetric measurements for accurate cardiac assessment.

Main Methods:

  • Utilized idealized left ventricular (LV) geometry models (truncated prolate spheroid, paraboloid).
  • Calculated cross-sectional areas and volumes from simulated LV shapes.
  • Employed a 3D reconstruction algorithm using multi-plane 2D ultrasound data.

Main Results:

  • Mathematical models showed area-based LVEF (41 ±4.7%) was lower than volume-based LVEF (55 ±5.7%).
  • 3D reconstruction yielded area-based LVEF (35 ±11.9%) and volume-based LVEF (48.0 ±14.0%).
  • Area-based LVEF consistently underestimated volume-based LVEF by 13-14% across models.

Conclusions:

  • 2D area-based LVEF measurements significantly underestimate true cardiac function.
  • Volume-based LVEF calculations provide a more accurate assessment of the left ventricle.
  • Accurate LVEF assessment necessitates volumetric analysis of the LV blood pool.