Real-time three-dimensional echocardiography to construct clinically ready, load-independent indices of myocardial contractile performance.
BACKGROUND
Real-time 3-dimensional echocardiography (RT3DE) reliably determines intracardiac chamber volumes without left ventricular (LV) geometric assumptions, yet clinical assessment of contractile performance is often on the basis of potentially inaccurate, load-dependent indices such as ejection fraction.


METHODS
In 6 chronically instrumented dogs, RT3DE estimated LV volumes at various loading conditions. Preload recruitable stroke work and end-systolic pressure-volume relationships were constructed. RT3DE-derived indices were compared with similar relationships determined by sonomicrometry.


RESULTS
Highly linear preload recruitable stroke work and end-systolic pressure-volume relationships were constructed by RT3DE and sonomicrometry. Mean preload recruitable stroke work slopes correlated between methods, but volume intercepts differed as a result of geometric assumptions of sonomicrometry. Conversely, RT3DE-derived end-systolic pressure-volume relationships did not correlate well with sonomicrometry.


CONCLUSIONS
These data are unique in reporting load-independent measures of LV performance using RT3DE. These techniques would strengthen evaluation of LV function after myocardial ischemia or cardiac operation, in which frequent changes in ventricular geometry or loading conditions confound functional assessment by more traditional methods.
Atkins
B Zane
BZ
Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA. broadus.atkins@lackland.af.mil
Kuo
Johnny
J
Shah
Ashish S
AS
Hutcheson
Kelley A
KA
Glower
Donald D
DD
von Ramm
Olaf T
OT
D000818:Animals; D002122:Calcium Chloride / Q000494:pharmacology; D003199:Computer Systems; D004195:Disease Models, Animal; D004285:Dogs; D019560:Echocardiography, Three-Dimensional; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D007262:Infusions, Intravenous; D008955:Models, Cardiovascular; D009200:Myocardial Contraction / Q000187:drug effects / Q000502:physiology*; D017202:Myocardial Ischemia / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000503:physiopathology; D013223:Statistics as Topic; D013268:Stimulation, Chemical; D013318:Stroke Volume / Q000502:physiology
D002122:Calcium Chloride