title: The utility of fully automated real-time three-dimensional echocardiography in the evaluation of left ventricular diastolic function.
abstract: BACKGROUND
  A novel real-time three-dimensional echocardiography (RT3DE) system allows fully automated quantification of the left ventricular (LV) volume throughout a cardiac cycle. This study aimed to investigate whether an LV time-volume curve, obtained using fully automated RT3DE, is useful in the evaluation of LV diastolic function.
  
  
  METHODS
  First, 15 patients underwent simultaneous standard two-dimensional echocardiography (2DE), RT3DE, and cardiac catheterization to measure the time constant of the isovolumic-pressure decline (τ). From the LV time-volume curve obtained using RT3DE, peak early filling rate (PFR) during diastole was generated and indexed for LV end-systolic volume. Next 570 patients, who were scheduled for both 2DE and RT3DE examinations, were enrolled to investigate the association between PFR index and 2DE-evidenced diastolic dysfunction and clinical characteristics.
  
  
  RESULTS
  Of the 585 patients, RT3DE analysis was adequate in 542 patients (feasibility 93%). In the 15 patients, PFR index showed significant correlation with τ (r=-0.65, p=0.009). In the remaining 527 patients, PFR index was related to age (r=-0.24, p<0.001) and e' (r=0.41, p<0.001). PFR index decreased in proportion to the grade of 2DE-evidenced diastolic dysfunction. All patients with normal diastolic function had a PFR index greater than 2.0.
  
  
  CONCLUSIONS
  This study demonstrated that a novel, fully automated RT3DE-derived PFR index was the diagnostic tool of choice for the assessment of LV diastolic function.
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Nakanishi
authors.affiliation: Department of Medicine, Osaka Ekisaikai Hospital, Osaka, Japan. Electronic address: h-syouta@mve.biglobe.ne.jp.
authors.forename: Shota
authors.initials: S
authors.lastname: Fukuda
authors.affiliation: Heart Center, Tokyo Bay Urayasu/Ichikawa Medical Center, Urayasu, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Seo
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, Fuchu, Japan.
authors.forename: Keitaro
authors.initials: K
authors.lastname: Mahara
authors.affiliation: Nishinomiya Watanabe Cardiovascular Center, Nishinomiya, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Hyodo
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Otsuka
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Ishizu
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kenei
authors.initials: K
authors.lastname: Shimada
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, Fuchu, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sumiyoshi
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Aonuma
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, Fuchu, Japan.
authors.forename: Hitonobu
authors.initials: H
authors.lastname: Tomoike
authors.affiliation: Nishinomiya Watanabe Cardiovascular Center, Nishinomiya, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D003971:Diastole; D004452:Echocardiography / Q000379:methods; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Diagnosis; Diastolic dysfunction; Echocardiography