title: Freehand three-dimensional echocardiography with rotational scanning for measurements of left ventricular volume and ejection fraction in patients with coronary artery disease.
abstract: BACKGROUND
  Measurement of left ventricular (LV) volumes and ejection fraction (EF) is important in managing patients with coronary artery disease (CAD). Introduction of free-hand three-dimensional echocardiography (3DE) system which is equipped with small magnetic tracking system and average rotational geometry for LV volumes may provide easy and accurate quantification of LV systolic function in CAD patients.
  
  
  OBJECTIVE
  To evaluate the feasibility and accuracy of LV volumes and EF measurement by free-hand 3DE with rotational geometry in patients with CAD.
  
  
  RESULTS
  The study subjects consisted of consecutive 25 patients with CAD who were scheduled for quantitative gated single-photon emission computed tomography (QGS). LV end-diastolic volume (EDV), end-systolic volume (ESV), and EF were determined by conventional two-dimensional echocardiography (2DE), 3DE, and QGS. Three-dimensional echocardiography data acquisition and analysis were possible in 22 of 25 subjects (feasibility 88%). In this 3DE system, image acquisition time was 2 minutes, and 5 minutes were needed for off-line analysis of LV volumes and EF. Correlations and the limits of agreement between 3DE and QGS (r = 0.97, 0.0 +/- 9.1 ml for EDV, r = 0.99, 0.0 +/- 5.0 ml for ESV, and r = 0.97, 0.5 +/- 3.3% for EF, respectively) were superior to those between 2DE and QGS (r = 0.85, 12.6 +/- 26.8 ml for EDV, r = 0.85, 9.7 +/- 26.1 ml for ESV, and r = 0.90, -1.3 +/- 6.9% for EF, respectively). Inter- and intra-observer variabilities of 3DE were smaller than that of 2DE (5% vs 10%, 5% vs 10% for EDV, 6% vs 13%, 5% vs 9% for ESV, and 4% vs 11%, 4% vs 6% for EF, respectively).
  
  
  CONCLUSIONS
  Three-dimensional echocardiography using magnetic tracking system and average rotational geometry offered a feasible and accurate method for quantification of LV volumes and EF in patients with CAD.
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan.
authors.forename: Shota
authors.initials: S
authors.lastname: Fukuda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hozumi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Takashi
authors.initials: T
authors.lastname: Muro
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamagishi
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Takeuchi
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D019560:Echocardiography, Three-Dimensional / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D013318:Stroke Volume; D015899:Tomography, Emission-Computed, Single-Photon; D016277:Ventricular Function, Left