title: Value of real time three-dimensional echocardiography in patients with hypertrophic cardiomyopathy: comparison with two-dimensional echocardiography and magnetic resonance imaging.
abstract: Real time three-dimensional echocardiography (RT3DE) has been demonstrated to be an accurate technique to quantify left ventricular (LV) volumes and function in different patient populations. We sought to determine the value of RT3DE for evaluating patients with hypertrophic cardiomyopathy (HCM), in comparison with cardiac magnetic resonance imaging (MRI).
  
  
  METHODS
  We studied 20 consecutive patients with HCM who underwent two-dimensional echocardiography (2DE), RT3DE, and MRI. Parameters analyzed by echocardiography and MRI included: wall thickness, LV volumes, ejection fraction (LVEF), mass, geometric index, and dyssynchrony index. Statistical analysis was performed by Lin agreement coefficient, Pearson linear correlation and Bland-Altman model.
  
  
  RESULTS
  There was excellent agreement between 2DE and RT3DE (Rc = 0.92), 2DE and MRI (Rc = 0.85), and RT3DE and MRI (Rc = 0.90) for linear measurements. Agreement indexes for LV end-diastolic and end-systolic volumes were Rc = 0.91 and Rc = 0.91 between 2DE and RT3DE, Rc = 0.94 and Rc = 0.95 between RT3DE and MRI, and Rc = 0.89 and Rc = 0.88 between 2DE and MRI, respectively. Satisfactory agreement was observed between 2DE and RT3DE (Rc = 0.75), RT3DE and MRI (Rc = 0.83), and 2DE and MRI (Rc = 0.73) for determining LVEF, with a mild underestimation of LVEF by 2DE, and smaller variability between RT3DE and MRI. Regarding LV mass, excellent agreement was observed between RT3DE and MRI (Rc = 0.96), with bias of-6.3 g (limits of concordance = 42.22 to-54.73 g).
  
  
  CONCLUSIONS
  In patients with HCM, RT3DE demonstrated superior performance than 2DE for the evaluation of myocardial hypertrophy, LV volumes, LVEF, and LV mass.
authors.affiliation: Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Letícia S
authors.initials: LS
authors.lastname: Bicudo
authors.forename: Jeane M
authors.initials: JM
authors.lastname: Tsutsui
authors.forename: Afonso
authors.initials: A
authors.lastname: Shiozaki
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Rochitte
authors.forename: Edmundo
authors.initials: E
authors.lastname: Arteaga
authors.forename: Charles
authors.initials: C
authors.lastname: Mady
authors.forename: José A F
authors.initials: JA
authors.lastname: Ramires
authors.forename: Wilson
authors.initials: W
authors.lastname: Mathias
mesh_terms: D000293:Adolescent; D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000473:pathology*; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011336:Probability; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013318:Stroke Volume; D055815:Young Adult