Quantitation of left ventricular volumes and ejection fraction in post-infarction patients from biplane and single plane two-dimensional echocardiograms. A prospective longitudinal study of 371 patients.
OBJECTIVE
To determine whether left ventricular volumes and ejection fractions calculated from single plane two-dimensional echocardiograms using the algorithm (0.85A2L) correlate with those calculated using the biplane Simpson's method, and whether small changes in volumes and ejection fraction occurring post-infarction could be detected from single-plane as well as from biplane two-dimensional echocardiograms.


RESULTS
Serial two-dimensional echocardiograms were obtained in 371 patients from the DEFIANT II trial a mean of 2 days, 1 week and 6 months post-infarction. Single plane volumes from the apical four chamber and apical long axis correlated closely with biplane Simpson's left ventricular volumes. Both single-plane left ventricular volumes significantly over-estimated biplane Simpson's volumes. Biplane Simpson's ejection fractions were consistently slightly under-estimated from the single-plane images. Differences between biplane Simpson's and single-plane volumes increased independently with increasing left ventricular size and distortion. The small changes in left ventricular volumes and ejection fraction over time were as reliably detected from single plane as from biplane images.


CONCLUSIONS
Single-plane left ventricular volumes over-estimate biplane Simpson's volumes and under-estimate ejection fraction, and these discrepancies are amplified in dilated hearts with abnormal shape.
St John Sutton
M
M
Cardiovascular Division, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
Otterstat
J E
JE
Plappert
T
T
Parker
A
A
Sekarski
D
D
Keane
M G
MG
Poole-Wilson
P
P
Lubsen
K
K
D000328:Adult; D000368:Aged; D002306:Cardiac Volume / Q000187:drug effects / Q000502:physiology*; D004311:Double-Blind Method; D004452:Echocardiography / Q000187:drug effects; D005080:Exercise Test / Q000187:drug effects; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D015737:Nisoldipine / Q000008:administration & dosage; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology*
D014665:Vasodilator Agents; D015737:Nisoldipine