title: Non-Invasive Evaluation of Heart Function with Four-Dimensional Echocardiography.
abstract: The aim of this study is to assess the accuracy and feasibility of left ventricular systolic function determined by four-dimensional echocardiography (4DE).
  
  
  
  Latex balloons were sewn into the left ventricle (LV) of 20 freshly harvested pig hearts which were then passively driven by a pulsatile pump apparatus. Global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS) and left ventricular ejection fraction (LVEF) derived from 4DEand two-dimensional echocardiography (2DE)-derived LVEF were quantified at different stroke volumes (SV) 30-70 ml and correlated with sonomicrometry data.
  
  
  
  In all comparisons, GLS, GCS, GAS, 2DE-LVEF, and 4DE-LVEF demonstrated strong correlations with sonomicrometry data (r = 0.77, r = 0.89, r = 0.79, r = 0.93, r = 0.96, all P <0.001). Bland-Altman analyses showed slight overestimations of echo-derived GLS, GCS, 2DE-LVEF and 3DE-LVEF over sonomicrometry values (bias = 2.88, bias = 3.99, bias = 3.37, bias = 2.78, respectively). Furthermore, there is better agreement between GCS, 4D LVEF and sonomicrometry values compared with GLS and 2D LVEF.
  
  
  
  Four-dimensional echocardiography accurately assesses LV function. GCS derived by 4DE is a potential alternative parameter to quantify LV systolic function.
authors.affiliation: Department of Diagnostic Ultrasound and Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China.|Division of Pediatric Cardiology, Oregon Health & Science University, Portland, OR, United States of America.
authors.forename: Ran
authors.initials: R
authors.lastname: Chen
authors.affiliation: Division of Pediatric Cardiology, Oregon Health & Science University, Portland, OR, United States of America.
authors.forename: Meihua
authors.initials: M
authors.lastname: Zhu
authors.affiliation: Division of Pediatric Cardiology, Oregon Health & Science University, Portland, OR, United States of America.
authors.forename: David J
authors.initials: DJ
authors.lastname: Sahn
authors.affiliation: Division of Pediatric Cardiology, Oregon Health & Science University, Portland, OR, United States of America.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Ashraf
mesh_terms: D000818:Animals; D004452:Echocardiography / Q000379:methods; D019561:Echocardiography, Four-Dimensional / Q000379:methods*; D019560:Echocardiography, Three-Dimensional / Q000379:methods; D006352:Heart Ventricles / Q000503:physiopathology*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D015203:Reproducibility of Results; D013318:Stroke Volume / Q000502:physiology; D013552:Swine; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*