| Objective 1 To investigate the feasibility and accuracy of real-time three-dimensional echocardiography (RT3DE) for quantifying left ventricular (LV) and cardiac mass in vitro compared with two-dimensional echocardiography (2DE). 2 To evaluate left ventricular global ejection fraction (LVEF) by RT3DE compared with M-mode echocardiography ( ME) . 3 To investigate the feasibility of RT3DE for analysis of left ventricular global and regional systolic and diastolic function using global and regional volume-time curves and ejection fraction-time curves.Methods 1 Two balloons separated by gel were suspended in a water bath. To mimic different LV chamber volumes and cardiac masses, 5 volumes of water within the inner balloon (74~200ml) and 5 volumes gel within inter-balloon (45~60ml), were scanned using 2~4MHz Max4 probe, RT3DE and 2DE image were acquired, measured by Volume Measurement System in 4D Cardio-View RT1.0 of Tom Tec and Simpson method respectively. 2 24 healthy participants examined by RT3DE and ME on their LVEF, and the results by the two methods were compared. 3 In 38 healthy participants, LV global and regional volume-time curves (VTC/ rVTC), global and reginal ejection fraction-time curves (EF-TC/ rEF-TC) were generated to analysis LV global and regional systolic and diastolic functional parameters such as LV global and regional end diastolic volume (EDV/rEDV), end systolic volume (ESV/rESV), stroke volume (SV/rSV), peak filling rate (PFR/rPFR), peak ejection rate (PER/rPER), EF and rigional EF (rEF) by RT3DE databanks from analysis software of Tom Tec, regressed and compared by statistic software.Results 1 5 models got good images of RT3DE and 2DE. RT3DE had a lower error and systematic bias than 2DE (p<0.05) totally. The volumes measured by RT3DE had correlation well with 2DE and the true volumes for different sizes andthickness of balloon (p>0.05). 2 24 subjects can acquire satisfactory RT3DE and ME images; normal LVEF was (62.61 ±5.4)% and (64 + 7.37)% in RT3DE and ME respectively. There were no statistically significant differences between RT3DE and ME (p>0.05), and there was good correlation (r=0.8 , p<0.001). 3 38 participants acquire satisfactory RT3DE images, data, LV global and regional VTC/rVTC and EF-TC/rEF-TC. Those LV global function parameters were: EDV (84.32 + 18.81) ml, ESV ( 3 1.44 + 8.85 ) ml, SV ( 60.36 + 23.29 ) ml, PFR ( 220.49 + 103.63) ml/s, PER (301.46+ 112.97) ml/s, EF ( 62.63 1+6.611 ) %; LV regional function parameters were: BASE (B): rPFR (120.66 + 64.05)ml/s, PER (141.69 + 52.33)ml/s; MID VENTRICLE (M): rPFR (111.08 + 63.80)ml/s, rPER (128.08 + 47.04)ml/s; APEX (A): rPEF (79.30 + 51.1 7)ml/s, rPER (89.20 + 41.83)ml/s, rPER (301.46+112.97)ml/s, ANT (AN): rPFR (61.34 + 35.97) ml/s, rPER (69.66 + 29.09) ml/s; INF (I): rPFR (60.24 + 35.77) ml/s, rPER (69.78 + 32.44) ml/s. In all or regional detection, PER>PFR. In rPFR and rPER: B>M>A, and AN>I. There was no significant difference between B and M, AN and I in both PER and PFR (p>0.05). There was good correlation between A, M and B or AN and I in PFR and PER (p<0.001). The difference among the 16 segmental rEFs was significant (p=0.000), and A was maximal.Conclusion RT3DE is a great outbreak in the development ofechocardiology. The operators' degree influences RT3DE imaging mildly. RT3DE provide an accurate mean of determining chamber volume, cardiac mass and cardiac function without geometry formulae. Generation of LV global and regional VTC/rVTC and EF-TC/rEF-TC by RT3DE is feasible. RT3DE a promising approach providing access to quantitative information on LV global and regional systolic and diastolic function. |
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