Key result
Parasternal 3-D echocardiography improved interobserver reproducibility for left ventricular mass estimates (coefficient of variation 4.7%) compared to 2-D methods (8.1-9.4%).
Why the study?
Does 3-D echocardiography improve the accuracy and reproducibility of left ventricular mass measurement compared to 2-D echocardiography in an in vitro porcine model?
Does 3-D echocardiography improve the accuracy and reproducibility of left ventricular mass measurement compared to 2-D echocardiography in an in vitro porcine model?
Parasternal 3-D echocardiography improves the reproducibility of left ventricular mass estimates compared to 2-D methods in an in vitro model, though at the expense of greater time consumption.
Hypothesis-generating for 3-D echocardiography in LV mass assessment; prospective human studies needed before clinical adoption.
BACKGROUND: The reproducibility of left ventricular (LV) mass measurement by two-dimensional (2-D) echocardiography is inadequate for individual assessments. HYPOTHESIS: This study was undertaken to evaluate the potential of LV mass determination with a new three-dimensional (3-D) echocardiographic method compared with 2-D measurements. METHODS: Porcine agarose-filled left ventricles (n = 15, true mass 61-511 g) of different shapes were measured by a multiplane 3-D method based on 90 images acquired by probe rotation axis (1) perpendicular and (2) parallel to the ventricular long axis ["parasternal" (the left sternal border was not present as a reference point in this study) and apical views]. Mass was also obtained using (3) the biplane truncated ellipsoid and (4) area-length methods, as well as (5) the modified cube formula. Five hearts were not analyzed with the apical 3-D technique because of insufficient image quality. RESULTS: Systematic deviation from true mass was small with all methods (< 5.3%). Accuracy, expressed as 1 standard deviation of individual estimates around this systematic bias, was 7.7, 13.6, 8.2, 11.9, and 11.9% of true mass for the methods 1-5, respectively. Interobserver reproducibility, expressed as the coefficient of variation, was 4.7, 8.8, 8.1, 8.9, and 9.4% for the same methods. CONCLUSION: Limits for individual accuracy and reproducibility of LV mass estimates are nearly doubled using apical compared with "parasternal" 3-D echocardiography in vitro. A main advantage of "parasternal" 3-D compared with 2-D LV mass estimates is better reproducibility, but at the expense of greater time consumption. Apical 3-D technique is not superior to simpler 2-D methods based on "parasternal" short axis imaging.
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Rødevand et al. (1997) studied Left ventricular mass measurement (n=15). Multiplane 3-D echocardiography vs. 2-D echocardiography methods was evaluated on Accuracy and interobserver reproducibility of LV mass estimates. Parasternal 3-D echocardiography improved interobserver reproducibility for left ventricular mass estimates (coefficient of variation 4.7%) compared to 2-D methods (8.1-9.4%).
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