Comparison of two- and three-dimensional echocardiography with cineventriculography for measurement of left ventricular volume in patients.
OBJECTIVE
We compared two- and three-dimensional echocardiography with cineventriculography for measurement of left ventricular volume in patients.


BACKGROUND
Three-dimensional echocardiography has been shown to be highly accurate and superior to two-dimensional echocardiography in measuring left ventricular volume in vitro. However, there has been little comparison of the two methods in patients.


METHODS
Two- and three-dimensional echocardiography were performed in 35 patients (mean age 48 years) 1 to 3 h before left ventricular cineventriculography. Three-dimensional echocardiography used an acoustic spatial locator to register image position. Volume was computed using a polyhedral surface reconstruction algorithm based on multiple nonparallel, unevenly spaced short-axis cross sections. Two-dimensional echocardiography used the apical biplane summation of disks method. Single-plane cineventriculographic volumes were calculated using the summation of disks algorithm. The methods were compared by linear regression and a limits of agreement analysis. For the latter, systematic error was assessed by the mean of the differences (cineventriculography minus echocardiography), and the limits of agreement were defined as +/- 2 SD from the mean difference.


RESULTS
Three-dimensional echocardiographic volumes demonstrated excellent correlation (end-diastole r = 0.97; end-systole r = 0.98) with cineventriculography. Standard errors of the estimate were approximately half of those of two-dimensional echocardiography (end-diastole +/- 11.0 ml vs. +/- 21.5 ml; end-systole +/- 10.2 ml vs. +/- 17.0 ml). By limits of agreement analysis the end-diastolic mean differences for two- and three-dimensional echocardiography were 21.1 and 12.9 ml, respectively. The limits of agreement (+/- 2 SD) were +/- 54.0 and +/- 24.8 ml, respectively. For end-systole, comparable improvement was obtained by three-dimensional echocardiography. Results for ejection fraction by the two methods were similar.


CONCLUSIONS
Three-dimensional echocardiography correlates highly with cineventriculography for estimation of ventricular volumes in patients and has approximately half the variability of two-dimensional echocardiography for these measurements. On the basis of this study, three-dimensional echocardiography is the preferred echocardiographic technique for measurement of ventricular volume. Three-dimensional echocardiography is equivalent to two-dimensional echocardiography for measuring ejection fraction.
Sapin
P M
PM
Division of Cardiology, University of Kentucky Medical Center, Lexington 40536.
Schröder
K M
KM
Gopal
A S
AS
Smith
M D
MD
DeMaria
A N
AN
King
D L
DL
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002306:Cardiac Volume; D002932:Cineangiography; D004452:Echocardiography / Q000379:methods; D005260:Female; D006331:Heart Diseases / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012044:Regression Analysis; D016277:Ventricular Function, Left