TY - JOUR
T1 - Comparison of real-time three-dimensional echocardiography with cardiovascular magnetic resonance for left ventricular volumetric assessment in unselected patients
AU - Miller, Christopher A.
AU - Pearce, Keith
AU - Jordan, Peter
AU - Argyle, Rachel
AU - Clark, David
AU - Stout, Martin
AU - Ray, Simon G.
AU - Schmitt, Matthias
PY - 2012/2
Y1 - 2012/2
N2 - Aims: To compare left ventricular (LV) volume indices and the ejection fraction (EF) obtained using real-time three-dimensional echocardiography (RT3DE) and cardiovascular magnetic resonance (CMR) in unselected patients representative of 'real-world' clinical practice, and to determine the effect of RT3DE image quality on these parameters. Methods and results: Sixty consecutive patients undergoing CMR underwent same day RT3DE. LV volume and EF measurements were made using both modalities and compared. All scans were independently analysed by a second observer to assess inter-observer variability, and 40% were re-analysed to assess intra-observer variability. RT3DE image quality was graded as good, adequate, and non-analysable. Thirteen (22%) patients had good RT3DE image quality, 29 (48%) had adequate image quality, and 18 (30%) had image quality precluding analysis. Body mass index and arrhythmia frequency were higher in patients with suboptimal image quality. RT3DE significantly underestimated end-diastolic volume (EDV) (-45±35 mL, P <0.001), end-systolic volume (ESV) (-11±24 mL, P = 0.004), and EF (-7±9%, P <0.001) compared with CMR although the degree of underestimation was substantially less when image quality was good. Eleven patients (18%) classified as having a normal EF by CMR had a reduced EF according to RT3DE, all but one of which had suboptimal image quality. Observer variability for RT3DE was higher than for CMR for all parameters, however, the difference was not significant when RT3DE image quality was good. Conclusions: In contrast to previously published data from highly selected patient groups, 'real-world' RT3DE substantially underestimates LV volumes and EF. The degree of underestimation is related to image quality. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2011.
AB - Aims: To compare left ventricular (LV) volume indices and the ejection fraction (EF) obtained using real-time three-dimensional echocardiography (RT3DE) and cardiovascular magnetic resonance (CMR) in unselected patients representative of 'real-world' clinical practice, and to determine the effect of RT3DE image quality on these parameters. Methods and results: Sixty consecutive patients undergoing CMR underwent same day RT3DE. LV volume and EF measurements were made using both modalities and compared. All scans were independently analysed by a second observer to assess inter-observer variability, and 40% were re-analysed to assess intra-observer variability. RT3DE image quality was graded as good, adequate, and non-analysable. Thirteen (22%) patients had good RT3DE image quality, 29 (48%) had adequate image quality, and 18 (30%) had image quality precluding analysis. Body mass index and arrhythmia frequency were higher in patients with suboptimal image quality. RT3DE significantly underestimated end-diastolic volume (EDV) (-45±35 mL, P <0.001), end-systolic volume (ESV) (-11±24 mL, P = 0.004), and EF (-7±9%, P <0.001) compared with CMR although the degree of underestimation was substantially less when image quality was good. Eleven patients (18%) classified as having a normal EF by CMR had a reduced EF according to RT3DE, all but one of which had suboptimal image quality. Observer variability for RT3DE was higher than for CMR for all parameters, however, the difference was not significant when RT3DE image quality was good. Conclusions: In contrast to previously published data from highly selected patient groups, 'real-world' RT3DE substantially underestimates LV volumes and EF. The degree of underestimation is related to image quality. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2011.
KW - Cardiovascular magnetic resonance
KW - Ejection fraction
KW - Image quality
KW - Left ventricle
KW - Real time three-dimensional echocardiography
U2 - 10.1093/ejechocard/jer248
DO - 10.1093/ejechocard/jer248
M3 - Article
C2 - 22109245
SN - 2047-2404
VL - 13
SP - 187
EP - 195
JO - European heart journal. Cardiovascular Imaging
JF - European heart journal. Cardiovascular Imaging
IS - 2
ER -