3D transthoracic echocardiography is not used routinely to quantify LV volumes and EF. A fully automated workflow using RT-VTTE may improve clinical adoption.
RT-VTTE was performed and 3D EF and volumes obtained using an automated trabecular endocardial contouring algorithm; an automated correction was applied to track the compacted myocardium. Cardiac magnetic resonance (CMR) and 2-dimensional biplane Simpson method were the reference standard.
Ninety-one patients (67 in normal sinus rhythm [NSR], 24 in AF) were included. Among all NSR patients, there was excellent correlation between RT-VTTE and CMR for end-diastolic volume (EDV), end-systolic volume (ESV), and EF (r = 0.90, 0.96, and 0.98, respectively; p < 0.001). In patients with EF ?0 % (n = 36), EDV and ESV were underestimated by 10.7 ¡À 17.5 ml (p = 0.001) and by 4.1 ¡À 6.1 ml (p < 0.001), respectively. In those with EF <50 % (n = 31), EDV and ESV were underestimated by 25.7 ¡À 32.7 ml (p < 0.001) and by 16.2 ¡À 24.0 ml (p = 0.001). Automated contour correction to track the compacted myocardium eliminated mean volume differences between RT-VTTE and CMR. In patients with AF, LV volumes and EF were accurate by RT-VTTE (r = 0.94, 0.94, and 0.91 for EDV, ESV, and EF, respectively; p < 0.001). Automated 3D LV volumes and EF were highly reproducible.
Rapid, accurate, and reproducible EF can be obtained by RT-VTTE in NSR and AF patients by using an automated trabecular edge contouring algorithm. Furthermore, automated contour correction to detect the compacted myocardium yields accurate and reproducible 3D LV volumes.