title: Validation of real-time three-dimensional echocardiography for quantifying left ventricular volumes in the presence of a left ventricular aneurysm: in vitro and in vivo studies.
abstract: OBJECTIVE
  To validate the accuracy of real-time three-dimensional echocardiography (RT3DE) for quantifying aneurysmal left ventricular (LV) volumes.
  
  
  BACKGROUND
  Conventional two-dimensional echocardiography (2DE) has limitations when applied for quantification of LV volumes in patients with LV aneurysms.
  
  
  METHODS
  Seven aneurysmal balloons, 15 sheep (5 with chronic LV aneurysms and 10 without LV aneurysms) during 60 different hemodynamic conditions and 29 patients (13 with chronic LV aneurysms and 16 with normal LV) underwent RT3DE and 2DE. Electromagnetic flow meters and magnetic resonance imaging (MRI) served as reference standards in the animals and in the patients, respectively. Rotated apical six-plane method with multiplanar Simpson's rule and apical biplane Simpson's rule were used to determine LV volumes by RT3DE and 2DE, respectively.
  
  
  RESULTS
  Both RT3DE and 2DE correlated well with actual volumes for aneurysmal balloons. However, a significantly smaller mean difference (MD) was found between RT3DE and actual volumes (-7 ml for RT3DE vs. 22 ml for 2DE, p = 0.0002). Excellent correlation and agreement between RT3DE and electromagnetic flow meters for LV stroke volumes for animals with aneurysms were observed, while 2DE showed lesser correlation and agreement (r = 0.97, MD = -1.0 ml vs. r = 0.76, MD = 4.4 ml). In patients with LV aneurysms, better correlation and agreement between RT3DE and MRI for LV volumes were obtained (r = 0.99, MD = -28 ml) than between 2DE and MRI (r = 0.91, MD = -49 ml).
  
  
  CONCLUSIONS
  For geometrically asymmetric LVs associated with ventricular aneurysms, RT3DE can accurately quantify LV volumes.
authors.affiliation: Cardiovascular Imaging Center, Department of Caridology, the Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: J X
authors.initials: JX
authors.lastname: Qin
authors.forename: M
authors.initials: M
authors.lastname: Jones
authors.forename: T
authors.initials: T
authors.lastname: Shiota
authors.forename: N L
authors.initials: NL
authors.lastname: Greenberg
authors.forename: H
authors.initials: H
authors.lastname: Tsujino
authors.forename: M S
authors.initials: MS
authors.lastname: Firstenberg
authors.forename: P C
authors.initials: PC
authors.lastname: Gupta
authors.forename: A D
authors.initials: AD
authors.lastname: Zetts
authors.forename: Y
authors.initials: Y
authors.lastname: Xu
authors.forename: J
authors.initials: J
authors.lastname: Ping Sun
authors.forename: L A
authors.initials: LA
authors.lastname: Cardon
authors.forename: J A
authors.initials: JA
authors.lastname: Odabashian
authors.forename: S D
authors.initials: SD
authors.lastname: Flamm
authors.forename: R D
authors.initials: RD
authors.lastname: White
authors.forename: J A
authors.initials: JA
authors.lastname: Panza
authors.forename: J D
authors.initials: JD
authors.lastname: Thomas
mesh_terms: D000818:Animals; D003199:Computer Systems; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006322:Heart Aneurysm / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019047:Phantoms, Imaging; D012756:Sheep; D013318:Stroke Volume; D016277:Ventricular Function, Left