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Updated: Sep 8, 2025
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
The Volume-Time Curve by Three-Dimensional Echocardiography in Chagas Cardiomyopathy: Insights into the Mechanism of
Airandes de Sousa Pinto1,2, Maria Carmo Pereira Nunes3, Carlos Alberto Rodrigues2
1Programa de Pós-Graduação em Ciências da Saúde e Medicina Tropical da Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil.
Insights
In Chagas cardiomyopathy, increased left ventricular end-diastolic volume compensates for reduced ejection fraction, maintaining stroke volume and flow. This adaptation preserves cardiac function despite severe systolic dysfunction.
Area of Science:
- Cardiology
- Medical Imaging
- Physiology
Background:
- Three-dimensional echocardiography (3D ECHO) generates left ventricular (LV) volume-time curves.
- These curves track LV volume changes throughout the cardiac cycle.
Purpose of the Study:
- To investigate hemodynamic adaptations in Chagas cardiomyopathy (CC).
- To utilize 3D ECHO-derived volume-time curves for CC hemodynamic assessment.
Main Methods:
- Cross-sectional study of 20 CC patients and 15 healthy controls.
- 3D ECHO acquired LV volume-time curves.
- Flow dynamics derived from the volume-time curve's first derivative using MATLAB.
Main Results:
- CC patients had significantly lower LV ejection fraction (29.8% vs. 57.7%).
- Stroke volume and ejection flow were similar between CC patients and controls.
- Increased LV end-diastolic volume in CC patients suggests a preload-dependent compensation mechanism.
Conclusions:
- Elevated LV end-diastolic volume is a key adaptation in Chagas cardiomyopathy.
- This compensatory mechanism helps maintain stroke volume and flow despite severe LV systolic dysfunction.
- 3D ECHO offers a non-invasive method to assess these hemodynamic adaptations.
Background:
Three-dimensional echocardiography (3D ECHO) allows the generation of a volume-time curve representative of changes in the left ventricular (LV) volume throughout the entire cardiac cycle.
Objective:
This study aims to demonstrate the hemodynamic adaptations present in Chagas cardiomyopathy (CC) by means of the volume and flow measurements obtained by the volume-time curve by 3D ECHO.
Methods:
Twenty patients with CC and 15 healthy subjects were prospectively enrolled in a cross-sectional design study. 3D ECHO was performed in all subjects and the volume over time curves of the LV was generated. The flow was obtained by the first derivative of the volume-time curve using the software MATLAB. Statistical significance was set at p<0.05.
Results:
Although CC patients had lower LV ejection fraction compared to the control group (29.8±7.5 vs. 57.7±6.1, p<0.001), stroke volume (61.5±25.2 vs. 53.8±21.0, p=0.364) and maximum ejection flow during systole (-360.3±147.5 vs. -305.6±126.0, p=0.231) were similar between the groups. Likewise, the maximum flow in the early diastolic filling phase and during atrial contraction was similar between groups. An increase in preload expressed by LV end diastolic volume (204.8±79.4 vs. 93.0±32.6), p<0.001) may maintain the flow and stroke volumes similar to the controls.
Conclusion:
Using a non-invasive tool, we demonstrated that an increase in LV end-diastolic volume may be the main adaptation mechanism that maintains the flow and stroke volumes in the setting of severe LV systolic dysfunction.
