April 25, 2026Journal of the American College of Cardiology
Reproducibility of Echocardiographic Techniques for Sequential Assessment of Left Ventricular Ejection Fraction and Volumes
Key result
Noncontrast 3DE shows ~40% lower temporal variability for sequential LVEF measurement versus 2D methods.
- n=56
Why the study?
Decisions regarding cancer therapy rely on temporal changes in EF, but the echocardiographic method with the lowest temporal variability was unknown.
Does noncontrast 3-dimensional echocardiography improve the reproducibility of sequential left ventricular ejection fraction and volume measurements compared to 2D methods in breast cancer patients undergoing chemotherapy?
Population
56 female breast cancer chemotherapy patients with stable LV function
Comparison
2D-biplane Simpson's method vs 2D-triplane vs 3DE with and without contrast
Design
Blinded prospective observational study
Follow-up
1 year
Authors
Discussion
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Implication
May improve reliability of serial LVEF monitoring during chemotherapy; leaves open effects on outcomes pending randomized validation.
Key Points
- This study aims to determine the most reliable echocardiographic method for assessing left ventricular ejection fraction and volumes during chemotherapy.
- Evaluated patients with breast cancer undergoing chemotherapy at five time points for stable cardiac function.
- Used comprehensive echocardiograms with 2D and 3D methodologies, blinded to clinical data.
- Assessed inter-, intra-, and test-retest variability in measurements.
- Noncontrast 3D echocardiography showed significantly lower temporal variability in left ventricular ejection fraction compared to 2D methods.
- Contrast administration improved temporal variability for LV end-diastolic volume measured by 2D biplane method.
- 3D echocardiography demonstrated the best overall variability and reliability in measurements.
Study Design
Type
Observational (n=56)
Blinding
Blinded to clinical data
Structured PICO
Does noncontrast 3-dimensional echocardiography improve the reproducibility of sequential left ventricular ejection fraction and volume measurements compared to 2D methods in breast cancer patients undergoing chemotherapy?
P
Population
56 female patients (mean age 54 ± 13 years) undergoing chemotherapy for breast cancer, with stable left ventricular function defined by normal global longitudinal strain (≤-16.0%) at up to 5 time points.
I
Intervention
Noncontrast 3-dimensional echocardiography (3DE)
C
Comparator
2D-biplane Simpson's method, 2D-triplane, and contrast-enhanced 2D/3D echocardiography
O
Outcome
Temporal variability of left ventricular ejection fraction and volumes over 1 yearsurrogate
Main Result
Absolute Event Rate: 0.06% vs 0.1%
Noncontrast 3D echocardiography is the most reproducible technique for sequential assessment of LVEF and volumes in patients undergoing chemotherapy, outperforming 2D methods.
Cite This Study
Thavendiranathan et al. (2012) conducted an observational in Breast cancer undergoing chemotherapy (n=56). Noncontrast 3-dimensional echocardiography (3DE) vs. 2D-biplane Simpson's method, 2D-triplane, and contrast-enhanced methods was evaluated on Temporal variability of left ventricular ejection fraction and volumes. Noncontrast 3-dimensional echocardiography had the lowest temporal variability for sequential LVEF measurement (0.06 vs >0.10 for 2D methods) over 1 year of follow-up.