Long-term prognostic significance of three-dimensional echocardiographic parameters of the left ventricle and left atrium.
OBJECTIVE
We sought to investigate the long-term prognostic significance of two- and three-dimensional echocardiography.


RESULTS
One hundred and seventy-eight consecutive outpatients underwent two-dimensional echocardiography and three-dimensional echocardiography for the assessment of LV volumes, mass, ejection fraction, and LA maximum and minimum volumes. After 45 months of follow-up, 31 patients (17%) had major cardiovascular events (death, myocardial infarctions, or stroke). From the two-dimensional echocardiography data, a significant time relationship to cardiovascular events was achieved only by LV end-systolic volume [hazard ratio (HR): 1.047; 95% confidence interval (CI): 0.994-1.083; P = 0.031] and mass (HR: 1.038; CI: 0.993-1.082; P = 0.019), whereas from three-dimensional echocardiography, all the examined variables: LV end-diastolic (HR: 1.014; CI: 1.003-1.025; P = 0.014) and end-systolic volume (HR:1.018; CI: 1.006-1.029; P = 0.003), ejection fraction (HR: 0.032; CI: 0.002-0.565; P = 0.019), mass (HR: 1.030; CI: 1.016-1.045; P < 0.001), LA maximum (HR: 1.055; CI: 1.031-1.080; P < 0.001) and minimum (HR: 1.049; CI: 1.028-1.070; P < 0.001) volumes, were found to bear a significant relationship to cardiovascular events. By multivariate analysis, three-dimensional echocardiography derived LA minimum volume was identified as the best independent predictor of adverse cardiovascular events (HR: 1.217; CI: 1.075-1.378; P = 0.002).


CONCLUSIONS
Owing to a superior accuracy, three-dimensional echocardiography derived parameters and most notably LA minimum volume provide more relevant information on outpatient prognosis.
Caselli
Stefano
S
Department of Cardiovascular and Respiratory Sciences, Sapienza University of Rome, Viale del Policlinico 155, Rome 00161, Italy. stefano.caselli@uniroma1.it
Canali
Emanuele
E
Foschi
Maria Laura
ML
Santini
Daria
D
Di Angelantonio
Emanuele
E
Pandian
Natesa G
NG
De Castro
Stefano
S
D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000401:mortality; D004452:Echocardiography; D019560:Echocardiography, Three-Dimensional / Q000379:methods; D015981:Epidemiologic Factors; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011379:Prognosis; D013318:Stroke Volume / Q000502:physiology; D013997:Time Factors; D016277:Ventricular Function, Left