title: Dual triggering improves the accuracy of left ventricular volume measurements by contrast-enhanced real-time 3-dimensional echocardiography.
abstract: Real-time 3-dimensional echocardiographic continuous imaging (CIM) with contrast underestimates left ventricular (LV) volumes. We studied the effects of dual-triggered (DT) acquisition on the accuracy of LV volume measurements for patients with poor acoustic windows. Real-time 3-dimensional echocardiographic imaging was performed in 20 patients during LV opacification (Definity) on the same day as cardiac magnetic resonance imaging. Both CIM and DT data were analyzed using custom software to calculate end-systolic volume (ESV) and end-diastolic volume (EDV), which were compared with the cardiac magnetic resonance reference. CIM correlated well with the cardiac magnetic resonance reference (EDV: r = 0.89; ESV: r = 0.93), but underestimated EDV and ESV by 17% and 19%, respectively. In contrast, DT resulted in higher correlation (EDV: r = 0.95; ESV: r = 0.96) and smaller biases (9% and 6%, respectively). In conclusion, because the accuracy of LV volume measurements depends on the acquisition strategy of contrast-enhanced real-time 3-dimensional echocardiographic images, the use of DT instead of the conventional CIM acquisition is recommended.
authors.affiliation: Noninvasive Cardiac Imaging Laboratory, University of Chicago, Chicago, Illinois, USA.
authors.forename: Enrico G
authors.initials: EG
authors.lastname: Caiani
authors.forename: Patrick
authors.initials: P
authors.lastname: Coon
authors.forename: Cristiana
authors.initials: C
authors.lastname: Corsi
authors.forename: Sascha
authors.initials: S
authors.lastname: Goonewardena
authors.forename: Dianna
authors.initials: D
authors.lastname: Bardo
authors.forename: Patrick
authors.initials: P
authors.lastname: Rafter
authors.forename: Lissa
authors.initials: L
authors.lastname: Sugeng
authors.forename: Victor
authors.initials: V
authors.lastname: Mor-Avi
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Lang
mesh_terms: D003199:Computer Systems; D004452:Echocardiography / Q000379:methods*; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*