Correlation of 3D Echocardiography With Cardiac MRI in Patients With Acute Left Ventricular Dysfunction in the Age Group of One Month to 18 Years

Objectives The objective of this study is to evaluate the correlation and agreement between three-dimensional echocardiography (3D-ECHO) and cardiac magnetic resonance imaging (CMR) in children with acute left ventricular (LV) dysfunction, specifically assessing end-diastolic volume (EDV), end-systolic volume (ESV), and left ventricular ejection fraction (LVEF) and to identify any associated systematic measurement errors. Methods An observational cohort study was conducted in New Delhi, India, over a period of 18 months from June 2021 to November 2022. A total of 16 children aged one month to 18 years with acute myocarditis or new-onset LV dysfunction were enrolled. Clinical details, laboratory parameters, echocardiography, and CMR findings were recorded. Correlations were assessed using Pearson's coefficient, and agreement was analyzed using Bland-Altman plots. Results A very strong positive correlation was found between 3D-ECHO and CMR for LVEF (r = 0.887; p < 0.0001). EDV and ESV also showed strong correlations between 3D-ECHO and CMR (r = 0.906 and r = 0.903, respectively). However, the Bland-Altman analysis revealed that 3D-ECHO consistently underestimated EDV (mean difference = -18.86; p = 0.034) and ESV (mean difference = -21.77; p = 0.014) compared to CMR, while LVEF showed good agreement (p = 0.619). Conclusion 3D-ECHO demonstrates strong correlation with CMR in assessing LVEF in children with acute LV dysfunction and may serve as a reliable bedside tool for systolic function evaluation. However, its underestimation of EDV and ESV highlights the continued role of CMR as the gold standard for precise volumetric assessment.