Single-plane and biplane echocardiography: use of targeted scan planes improves the estimates of left ventricular volume and shape for analysis of postinfarction remodeling.
OBJECTIVE
Acute myocardial infarction and subsequent left ventricular (LV) remodeling induce complex geometric changes quantifiable by 3-dimensional (3D) echocardiography. Our objective was to determine accurate 2-dimensional echocardiographic techniques for analysis of diastolic and systolic LV volume and shape in remodeled hearts.


METHODS
We obtained 3D apical scans from 16 patients at the acute stage, and at 1 and 6 months after acute myocardial infarction. LV volumes were calculated by 7 methods: (1) Teichholz; (2) Teichholz including the infarcted area; (3) single-plane area-length (AL) using a 2-chamber (2CH) view; (4) single-plane AL using a 4-chamber (4CH) view; (5) single-plane AL using a view including the infarcted area; (6) biplane AL using 2CH and 4CH views; and (7) biplane AL using a view including the infarction region and corresponding orthogonal view (method ALBMIO). LV shape was assessed by 5 methods: (1) a 2CH view; (2) a 4CH view; (3) a single-plane view including the infarcted area; (4) biplane (2CH and 4CH) views; and (5) biplane views including the infarction region and corresponding orthogonal view (method BMIO).


RESULTS
For end-diastolic and end-systolic LV volume assessments, all 7 methods correlated with the 3D reference, but method ALBMIO performed best (end-diastolic: r = 0.931, bias = 17.4 mL; end-systolic: r = 0.946, bias = 11.2 mL). For LV shape assessments, method BMIO showed the smallest difference from the 3D reference.


CONCLUSIONS
With 2-dimensional echocardiographic techniques, quantitative analysis of LV volume and shape is most accurate when a component scan plane is targeted through the infarcted myocardial region.
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Yasuhiko
Y
Takemoto
Kazuaki
K
Tanabe
Krishnaswamy
K
Chandrasekaran
Karla V
KV
Ballman
James B
JB
Seward
Marek
M
Belohlavek
D000368:Aged; D004452:Echocardiography / Q000379:methods; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020257:Ventricular Remodeling