Key result
Fully automated 3D echocardiography provides accurate and reproducible left ventricular ejection fraction assessment, though widespread clinical implementation remains limited by image quality dependency and the need for expert supervision.
Fully automated knowledge-based algorithms for left ventricular quantification may overcome current limitations of 3D echocardiography, facilitating its implementation in routine practice.
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Limits routine adoption of automated 3D echo LVEF assessment; leaves open whether algorithms can overcome image quality barriers.
Ejection fraction is one of the most powerful determinants of prognosis and is a crucial parameter for the determination of cardiovascular therapies in conditions such as heart failure, valvular conditions and ischaemic heart disease. Among echocardiographic methods, 3D echocardiography has been attributed as the preferred one for its assessment, given an increased accuracy and reproducibility. Full-volume multi-beat acquisitions are prone to stitching artefacts due to arrhythmias and require prolonged breath holds. Single-beat acquisitions exhibit a lower temporal resolution, but address the limitations of multi-beat acquisitions. If not fully automated, 3D echocardiography remains time-consuming and resource-intensive, with suboptimal observer variability, preventing its implementation in routine practice. Further developments in hardware and software, including fully automated knowledge-based algorithms for left ventricular quantification, may bring 3D echocardiography to a definite turning point.
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Spitzer et al. (2017) conducted a review in Left ventricular systolic dysfunction. Automated 3D Echocardiography vs. 2D Echocardiography and Cardiac Magnetic Resonance was evaluated. Fully automated 3D echocardiography provides accurate and reproducible left ventricular ejection fraction assessment, though widespread clinical implementation remains limited by image quality dependency and the need for expert supervision.
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