Left ventricular ejection fraction in children measured by three-dimensional echocardiography using a new transthoracic integrated 3D-probe A comparison with equilibrium radionuclide angiography

BACKGROUND: Three-dimensional echocardiography allows calculation of left ventricular ejection fraction without geometric assumption on the ventricular shape. Our aim was to validate this technique in a paediatric population with distorted ventricles. METHODS: Twenty-one patients aged 6 months to 17 years underwent equilibrium radionuclide angiography and three-dimensional echocardiography. Fourteen patients had dilated cardiomyopathy and seven had univentricular hearts. A new, easy to handle, transthoracic rotational probe was used and motion artefacts were limited during the rotation (3 degrees intervals with ECG and respiratory gating). Left ventricular volumes and ejection fraction were calculated using the Simpson's rule with 12 slices. RESULTS: Three-dimensional echocardiography correlated well with equilibrium radionuclide angiography for ejection fraction measurement (r = 0.90; the mean difference between the two methods being 3.8 +/- 6%). Intra-observer and inter-observer variabilities for 3D echocardiography were 2.4% and 4.5%. CONCLUSIONS: Three-dimensional echocardiography is an accurate, non-invasive, and reproducible methods to measure left ventricular ejection fraction in children.