Evaluation of Left Ventricular Mass in Different Cardiac Geometry Using Three-Dimensional Contrast-Enhanced...

Area of Science:

• Cardiology
• Medical Imaging
• Biomedical Engineering

Background:

• Accurate measurement of left ventricular mass (LVM) is crucial for diagnosing and managing cardiac conditions like hypertrophic cardiomyopathy (HCM) and other forms of left ventricle (LV) enlargement.
• Traditional 2D echocardiography (2DE) methods may overestimate LVM, potentially impacting clinical decisions.
• Contrast-enhanced 3D echocardiography (Contrast-3DE) and single-photon emission computed tomography (SPECT) are advanced imaging techniques used for cardiac assessment.

Purpose of the Study:

• To compare the accuracy of LVM measurements obtained by 2DE, contrast-enhanced 2DE (Contrast-2DE), 3DE, and Contrast-3DE against SPECT.
• To evaluate the effectiveness of contrast enhancement in reducing LVM overestimation by echocardiographic methods.
• To assess the agreement between different imaging modalities in patients with various cardiac conditions, including HCM, dilated cardiomyopathy (DCM), and ischemic cardiomyopathy (ICM).

Main Methods:

• A study cohort of 69 patients, including 23 with HCM, 26 with LV enlargement (16 DCM, 10 ICM), and 20 controls, underwent 2DE, Contrast-2DE, 3DE, Contrast-3DE, and SPECT.
• Left ventricular mass (LVM) was measured using 2DE-AL and 3DE methods and compared with SPECT reference values.
• Statistical analysis was performed to assess agreement (r-value) and deviation between methods, with particular attention to different patient groups.

Main Results:

• All echocardiographic methods (2DE-AL, Contrast-2DE-AL, 3DE, Contrast-3DE) systematically overestimated LVM compared to SPECT (P < 0.05).
• Contrast-3DE demonstrated the best agreement with SPECT for LVM measurement (r = 0.898, P < 0.001) with the smallest deviation (5.7 ± 23.1 g).
• 3DE showed greater LVM overestimation than Contrast-3DE in LV hypertrophy and enlargement groups. No significant difference in LVM was observed between 2DE with and without contrast in any patient group.

Conclusions:

• Contrast-3DE and SPECT provide consistent LVM measurements, particularly in cardiomyopathy patients, outperforming standard 2DE methods.
• Contrast enhancement significantly reduces the overestimation of LVM observed with non-contrast echocardiography.
• Contrast-3DE is a valuable tool for accurate LVM assessment, offering improved agreement with SPECT compared to other echocardiographic techniques.