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Updated: May 19, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Impact of a Fully Integrated "1-Click" Automated Left Ventricular Ejection Fraction Tool on Echocardiography
Parshan Mashhourinejad1, Darwin Yeung2, Michael Tsang2
1Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Background:
The Simpson's Biplane Method (SBM) is the recommended standard for clinical reporting of left ventricular ejection fraction (LVEF). However, visual estimation of LVEF is common practice. Automated tools for SBM offer rapid, reproducible volumetric LVEF calculations, but their real-world impact on reporting behaviour is unclear. We sought to characterize the impact of a "1-click" automatic LVEF tool on the prevalence of volumetric LVEF reporting.
Methods:
We examined a retrospective cohort of 50,718 adult transthoracic echocardiograms performed between February 2023 and February 2025. In February 2024, a "1-click" automated SBM-based LVEF tool was deployed as an update to the reporting software. Prevalence of volumetric vs visual LVEF reporting was assessed for 3 time points: pre-deployment (period A), early post-deployment (period B), and late post-deployment (period C). Interrupted time series and multivariable logistic regression were used to evaluate temporal trends, adjusting for demographics, image quality, patient class, LVEF < 50%, and interpreting physician.
Results:
Overall, 33.7% (n = 17,097) of reports included a volumetric LVEF, whereas 66.3% (n = 33,621) were visual estimates. Compared with period A, volumetric reporting did not significantly increase in period B (odds ratio 1.10, 95% confidence interval 0.99-1.22; P = 0.084) but rose significantly in period C (odds ratio 1.29, 95% confidence interval 1.12-1.48; P = 0.049). Volumetric reporting was more common in technically good studies, in cases with LVEF < 50% (83.2% vs 33% when > 50%) and varied widely across interpreting physicians (22%-46%).
Conclusions:
The deployment of an SBM-based automated tool was associated with a modest increase in volumetric LVEF reporting, highlighting the fact that technology availability alone does not ensure its adoption.
