Arq Bras Cardiol: Imagem cardiovasc 2020; 33(4): 1-6

Semiautomatic Quantification of Left Ventricular Ejection Fraction and Volumes by Two-Dimensional Echocardiography: Comparison with Automatic Three-Dimensional Echocardiography

DOI: 10.47593/2675-312X/20203304eabc98

Abstract

Background

Left ventricular ejection fraction is one of the most used echocardiographic parameters in clinical practice. Its estimation by two-dimensional manual method (Simpson method) has limited reproducibility and accuracy, and semi-automatic methods have been proposed. It becomes necessary to compare the semi-automatic two-dimensional method with more accurate methods of assessing left ventricular ejection fraction, such as measurement by automatic three-dimensional echocardiography.

Objective

To compare the left ventricular ejection fraction, and left ventricular end-diastolic and end-systolic volumes estimates by the semi-automatic two-dimensional method with those obtained using the automatic three-dimensional method.

Method

Observational cross-sectional study, including patients in sinus rhythm, left ventricular ejection fraction > 50% and without significant structural heart disease, submitted to transthoracic echocardiography. Student’s t test, Pearson’s coefficient and Bland-Altman analysis were used in the statistical analysis.

Results

Forty patients were included, 53% women, 35% with arterial hypertension, 25% with dyslipidemia, 10% diabetic, 10% smokers and 13% with previous angioplasty. The mean values of left ventricular ejection fraction by three-dimensional and two-dimensional were 62.1 ± 5.8% and 61.7 ± 5.9% (p = 0.50), respectively. There was a strong correlation between left ventricular ejection fraction determined by two-dimensional and three-dimensional (r = 0.75; p <0.001), as well as with left ventricular end-diastolic (r = 0.75; p <0.001) and end-systolic (r = 0.76; p < 0.001). There was good agreement between two-dimensional and three-dimensional left ventricular ejection fraction (mean difference: -0.39; 95% confidence interval -1.7-0.9).

Conclusion

Left ventricular ejection fraction estimated by the two-dimensional semi-automatic method showed good agreement with the automatic three-dimensional method. The findings suggest the two-dimensional semi-automatic method as a reliable alternative for assessing volumes and left ventricular ejection fraction.