Volume Measurement of the Left Ventricle in Children with Congenital Heart Defects: 3-Dimensional Echocardiography versus Angiocardiography

Abstract

Background: Volume measurement of the left ventricle is currently done by 2-dimensional echocardiography or angiocardiography. However, for the calculation of volumes by these methods, geometrical assumptions must be made. For a precise ventricular volumetry, independent of mathematical assumptions, imaging techniques as the 3-dimensional echocardiography (3D-echo) are required, which permit the imaging of the real ventricular shape. The aim of the study was therefore to detect, whether 3D-echocardiography is suitable for left ventricular volumetry in children with congenital heart disease and whether the 3D-echocadiographically measured volumes correlate sufficiently well with angiocardiographically measured left ventricular volumes. Methods: 102 children with congenital heart disease were investigated. For angiocardiographic left ventricular volume measurement Simpson’s rule was used. Results were corrected with Lange’s correction factors. The 3D-echo data sets were registered with a rotating transthoracic transducer. Ventricular volumes were calculated after manual planimetry by summation of the volumes of the single slices. Results: The left ventricular volume could be calculated by 3D-echo in 83% of patients of all ages. In comparison to angiocardiography, the measured volumes were 0.6 ± 3.3 ml (0.9 ± 25.8%) or 7.1 ± 28.4 ml (7.4 ± 12.1%) smaller during systole or diastole, respectively. The correlation coefficients r² were 0.89 for systolic and 0.93 for diastolic measurements after logarithmic transformation. Pressure or volume overload did not influence significantly the difference between the two methods. Conclusion: Transthoracic 3D-echocardiography with a rotating transmitter is feasible for volumetry of the left ventricle in most children. The volumes measured by 3D-echo were significantly smaller than those calculated from the angiocardiography by Simpson’s rule. The measurements were not influenced by the kind of load of the ventricle. The correlation between the two methods is good.

Assessment of Left Ventricular Volumes and Function by Real Time Three‐Dimensional Echocardiography in a Pediatric Population: A TomTec versus QLAB Comparison

“…However, due to its high cost, limited access, lack of portability and reduced feasibility when working with children, its use is limited in routine clinical practice. Echocardiography is a noninvasive, accurate, and feasible method for assessing the anatomical and functional abnormalities of children's hearts 2–6 …”

“…Echocardiography is a noninvasive, accurate, and feasible method for assessing the anatomical and functional abnormalities of children's hearts. [2][3][4][5][6] Motion-mode (1D) and two-dimensional (2D) echocardiography are dependent on geometric assumptions of the LV shape. It often leads to limited accuracy and reproducibility in LV measurements, attributed to the inadvertent use of foreshortened views and the dependence on elliptical geometric modeling.…”

Cardiac Resynchronization Therapy in Children

“…Techniques such as 3D echocardiography are proving useful in assessing synchronization of individual contracting segments in patients with single ventricles [32,33]. Multisite pacing was assessed in the acute postoperative setting in 26 patients, with single ventricles undergoing some form of surgical palliation [34].…”

Quantifizierung der rechtsventrikulären Funktion bei angeborenen Herzfehlern: Korrelation von 3D-Echokardiographie und MRT als sich ergänzende Methoden

“…Im Hinblick auf den linken Ventrikel steht die so genannte Flächen-Methode zur Verfügung, mit der mit minimalem Aufwand aus den 2D-Bildern das enddiastolische und endsystolische linksventrikuläre Volumen sowie die Ejektionsfraktion mit hoher Reproduzierbarkeit als wesentliche Parameter der Pumpfunktion abgeleitet werden können [3]. Grundlage dieses Verfahrens ist die Annahme einer elliptisch-zylindrischen Form des linken Ventrikels, die selbst bei morphologisch veränderten linken Ventrikeln weitgehend zutrifft [4]. Dagegen weist der rechte Ventrikel mit seiner Lage um den linken Ventrikel, der sehr starken Trabekulierung, dem bei einer Hypertrophie relativ prominenten apikalen Abschnitt und dem relativ langen subvalvulären Ausflusstrakt eine wesentlich komplexere Anatomie auf, die mit einem einfachen Modell nicht adäquat beschrieben werden kann, um eine näherungsweise Volumetrie mit einer Flächensum-mationsmethode zu erlauben [5 -7].…”