Assessment Of Volume And Function Of Left Ventricle In Patients With Left Ventricular Noncompaction By Real-time Three-dimensional Echocardiography

Part1. Assessment of regional function of left ventricle inadult patients with isolated left ventricular noncompactionby real-time three-dimensional echocardiographyObjective To assess regional systolic function of noncompacted and compacted leftventricular (LV) segments in adult patients with isolated left ventricularnoncompaction(ILVNC) with real-time three-dimentional echocardiography(RT-3DE).Methods This study comprised20patients (age8.75±15.11years,10men), who fullfilled stringent diagnostic criteria for ILVNC and compared to20age and gendermatched healthy controls subjects. According to16sub-division method which wasrecommended by American Society of Echocardiography, all myocardial segments ofthe20patients with ILVNC were divided into two groups: group of noncompactedsegments and group of compacted segments. The myocardial segments of20controlsubjects were divided into two paired groups (control group A and control group B)corresponding to the two groups of ILVNC patients according to one-by-one matchingrule. RT3DE was performed on both sets of subjects, in which global left ventricularend-diastolic volume (LVEDV), global left ventricular end-systolic volume(LVESV),global left ventricular ejection farction(LVEF), and regional end-diastolic volume (rEDV), regional end-systolic volume(rESV), regional ejection farction(rEF) wereassessed. In addition, the extent and severity of NC was assessed both in a qualitativeand quantitative manner.Result①In our research, LVEF in ILVNC patients were decresased (P<0.01), andLVEDV, LVESV were both increased (P<0.01).②Compared with control groups,both rEDV and rESV were increased and rEF was decreased in noncompacted andcompacted LV segaments (P<0.01).③There is no statistical difference betweenrEDV, rESV, rEF of noncompacted and compacted segaments (P>0.05).④The totalNC score per patient correlated positively with LVEDV and LVESV, and negativelywith LVEF.Conclutions①In the ILVNC patients, both noncompacted and compacted LVsegments had comparable increased regional volumes and reduced systolic function.②There is no statistical difference between the regional volumes, ejection fractions ofnoncompacted and compacted segaments in patients with ILVNC.③The extent andseverity of noncompation correlated positively with global volumes and negativelywith LV systolic function. Part2. The value of Contrast-Enhanced3DEfor assessment of left ventricular volume and function inpatients with left ventricular non-compactionObjective To evaluate the value of echo-contrast RT3DE for assessment of leftventricular volume and function in patients with Left ventricularnon-compaction(LVNC).Methods Twenty-one patients of LVNC were involved (age29.95±15.53years,12men) and underwent non-enhanced and contrast-enhanced RT3DE to evaluate leftventricular end-diastolic volume (LVEDV)，left ventricular end-systolic volume(LVESV)，left ventricular ejection fraction (LVEF). The endocardial border definitionof LV was graded for each of the16LV segments as follows:0=border invisible,1=border visualized only partially, and2=complete visualization of the border. Threeimage-quality groups (good, fair, and uninterpretable) were identified.Results①During contrast-enhanced RT3DE, as compared with non-enhancedRT3DE, the number of segments with complete visualization of the endocardialborder increased from55%to82%(P <0.01); and the number of patients with agood-quality echocardiogram increased from33%to81%(P <0.01).②Contrast-enhanced RT3DE provided significantly larger values of LVEDV (P<0.01)and LVESV (P<0.01) as compared with non-enhanced RT3DE; the values of LVEFwere not statistically different between the two techniques (P=0.07).③Intra-andinter-observer agreement for assessment of LV volumes and systolic functionimproved during contrast-enhanced RT3DE, as compared with non-enhanced RT3DE.Conclusions①Contrast-enhanced RT3DE can improve the endocardial bordervisualization, and increase the prevalence of good-quality echocardiograms.②Volumes measured by3DE are significantly larger when ultrasound contrast is used.③Contrast-enhanced RT3DE can significantly improve the reproducibility of LV volumes and function measurements.