OBJECTIVE: To compare a full-automated software to quantify 3D transthoracic
echocardiography namely, 3DE-HM (three-dimensional echocardiography HeartModel, Philips
Healthcare) with the traditional manual quantitative method (3DE-manual) for assessing
volumes of left atrial and ventricular volumes, and left ventricular ejection fraction
(LVEF).
METHODS: 3D full volume images acquired from 156 subjects were collected and
divided into 3 groups, which include 70 normal control cases (Group A), 17 patients with
left ventricular remodeling after acute myocardial infarction (AMI) (Group B), and 69
patients with left atrial remodeling secondary to hypertension (Group C). The 3DE-HM
method was used to quantify left ventricular end-diastolic volume (LVEDV), left
ventricular end-systolic volume (LVESV), left atrial end-systolic volume (LAESV), and left
ventricular ejection fraction (LVEF), respectively. The results were compared with those
obtained with the 3DE-manual method for correlation and consistency analyses. The
reproducibility of the 3DE-HM method was also evaluated.
RESULTS: There was a high correlation between LVEDV, LVESV, LAESV and LVEF
values obtained with the 3DE-HM method and those obtained using the 3DE-manual method
(r = 0.72 to 0.97). The correlation was strongest for Group B, patients
with left ventricular remodeling post-AMI also demonstrated the greatest degree of
morphologic changes. There was a significant difference in all parameters measured with
the 3DE-HM method in different groups (P < 0.05). The difference in
the measurements of LVEDV and LVESV between the two methods was greatest in patients in
Group B compared with patients with hypertension-induced left ventricular remodeling
(Group C) and in normal controls (Group A) (P < 0.05). Lastly, the
difference in the measurement of LAESV between the two methods was greater in patients
with hypertension-induced left ventricular remodeling (Group C) than that in the control
group (Group A) (P < 0.05). The post-processing time of the 3DE-HM
data was significantly shorter than that using the 3DE-manual method
(P < 0.05). There was no significant variability in repeated
measurements at different time points using the 3DE-HM method either between subjects in
different groups or within the same subject.
CONCLUSION: 3DE-HM is a quick and feasible method for left ventricular
quantification and is clinically applicable for evaluating patients with left atrial and
left ventricular remodeling.
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