Key result
Three-dimensional echocardiography-derived left atrial minimum volume was the best independent predictor of major cardiovascular events (HR 1.217; 95% CI 1.075-1.378; P=0.002).
Why the study?
Does three-dimensional echocardiography improve the prediction of major cardiovascular events compared to two-dimensional echocardiography in outpatients?
Cohort (n=178)
Does three-dimensional echocardiography improve the prediction of major cardiovascular events compared to two-dimensional echocardiography in outpatients?
Effect estimate: HR 1.217 (95% CI 1.075-1.378)
p-value: p=0.002
Three-dimensional echocardiography, particularly left atrial minimum volume, provides superior long-term prognostic information for major cardiovascular events compared to standard two-dimensional echocardiography in outpatients.
May aid outpatient risk stratification; leaves open whether 3D echo improves prediction over 2D measures.
AIMS: We sought to investigate the long-term prognostic significance of two- and three-dimensional echocardiography. METHODS AND 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). CONCLUSION: Owing to a superior accuracy, three-dimensional echocardiography derived parameters and most notably LA minimum volume provide more relevant information on outpatient prognosis.
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Caselli et al. (2009) conducted a cohort in Outpatients (n=178). Three-dimensional echocardiography vs. Two-dimensional echocardiography was evaluated on Major cardiovascular events (death, myocardial infarctions, or stroke) (HR 1.217, 95% CI 1.075-1.378, p=0.002). Three-dimensional echocardiography-derived left atrial minimum volume was the best independent predictor of major cardiovascular events (HR 1.217; 95% CI 1.075-1.378; P=0.002).
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