Three-dimensional echocardiographic assessment of left ventricular volume in different heart diseases using a fully automated quantification software

doi:10.12998/wjcc.v10.i13.4050

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World Journal of Clinical Cases

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World J Clin Cases. May 6, 2022; 10(13): 4050-4063
Published online May 6, 2022. doi: 10.12998/wjcc.v10.i13.4050

Table 1 Comparison of left ventricular volume and left ventricular ejection fraction measured by the different transthoracic echocardiographic methods in 4 groups (mean ± SD)

Parameter	3DQA	Teichholz	Biplane Simpson	3DQ	HM-NE	HM-RE
Group A (control group, n = 42)
LVEDV (mL)	77.5 ± 13.7	82.5 ± 11.6^a	70.6 ± 10.9^a	77.1 ± 15.4	91.0 ± 17.5^a	86.3 ± 15.9^a
LVESV (mL)	25.7 ± 5.3	27.5 ± 4.9	24.2 ± 4.5^a	26.3 ± 6.7	31.5 ± 6.9^a	29.6 ± 6.4^a
LVEF (%)	66.6 ± 4.3	66.5 ± 4.2	65.6 ± 3.4^a	65.8 ± 4.0^a	65.2 ± 4.2^a	65.5 ± 3.9^a
LAESV (mL)	36.8 ± 9.6	NS	35.2 ± 9.9^a	NS	41.2 ± 10.5^a	39.8 ± 10.6^a
Group B (DCM, n = 35)
LVEDV (mL)	147.4 ± 34.7	205.7 ± 52.7^a	162.7 ± 46.6^a	154.3 ± 38.0^a	187.5 ± 52.3^a	186.1 ± 45.8^a
LVESV (mL)	96.6 ± 30.0	132.4 ± 40.4^a	103.1 ± 36.1	99.7 ± 32.3^a	115.6 ± 39.0^a	119.6 ± 40.4^a
LVEF (%)	35.1 ± 9.5	36.2 ± 7.9	37.3 ± 8.8	35.9 ± 9.3	37.9 ± 11.1	35.9 ± 9.4
LAESV (mL)	60.4 ± 26.5	NS	62.9 ± 33.0	NS	68.0 ± 34.6^a	69.4 ± 33.1^a
Group C (SWMA, n = 41)
LVEDV (mL)	121.4 ± 50.8	183.8 ± 73.1^a	135.1 ± 51.7^a	124.7 ± 51.9^a	170.3 ± 57.7^a	162.5 ± 56.9^a
LVESV (mL)	74.2 ± 35.6	111.6 ± 56.4^a	79.6 ± 37.2	75.4 ± 35.3	94.5 ± 40.4^a	95.5 ± 40.2^a
LVEF (%)	40.0 ± 10.2	41.5 ± 10.1	42.4 ± 10.2	40.6 ± 8.4	45.3 ± 11.8^a	42.5 ± 8.6^a
LAESV (mL)	73.2 ± 51.0	NS	74.4 ± 53.5	NS	84.9 ± 57.4^a	82.4 ± 57.8^a
Group D (HCM, n = 32)
LVEDV (mL)	80.0 ± 21.5	104.8 ± 32.2^a	75.7 ± 21.6	80.6 ± 22.4	112.6 ± 27.1^a	105.6 ± 31.6^a
LVESV (mL)	27.8 ± 8.7	32.3 ± 12.3	24.7 ± 9.5^a	28.3 ± 9.5	47.1 ± 14.8^a	40.1 ± 14.0^a
LVEF (%)	65.1 ± 5.6	69.4 ± 6.4^a	67.6 ± 7.1^a	65.0 ± 5.7	58.3 ± 7.5^a	62.1 ± 5.6^a
LAESV (mL)	70.4 ± 30.5	NS	71.5 ± 38.5	NS	89.3 ± 45.3^a	83.1 ± 42.1^a

^aP < 0.05 is statistically significant.

NS: Not significant; 3DQA: Advanced cardiac three-dimensional quantification; 3DQ: Cardiac three-dimensional quantification; HM-NE: HeartModel without regional endocardial border editing; HM-RE: HeartModel with regional endocardial border editing; LVEDV: Left ventricular end-diastolic volume; LVESV: Left ventricular end-systolic volume; LVEF: Left ventricular ejection fraction; LAESV: Left atrial end-systolic volume; DCM: Dilated cardiomyopathy; SWMA: Segmental wall motion abnormality; HCM: Hypertrophic cardiomyopathy.

Table 2 Comparison of left ventricular volume and left ventricular ejection fraction measured by HeartModel with and without regional endocardial border editing (mean ± SD)

Group	HM-NE				HM-RE
Group	LVEDV (mL)	LVESV (mL)	LVEF (%)	LAESV (mL)	LVEDV (mL)	LVESV (mL)	LVEF (%)	LAESV (mL)
Group A	91.0 ± 17.5^a	31.5 ± 6.9^a	65.2 ± 4.2	41.2 ± 10.5^a	86.3 ± 15.9	29.6 ± 6.4	65.5 ± 3.9	39.8 ± 10.6
Group B	187.5 ± 52.3	115.6 ± 39.0	37.9 ± 11.1	68.0 ± 34.6	186.1 ± 45.8	119.6 ± 40.4	35.9 ± 9.4	69.4 ± 33.1
Group C	170.3 ± 57.7^a	94.5 ± 40.4	45.3 ± 11.8^a	84.9 ± 57.4^a	162.5 ± 56.9	95.5 ± 40.2	42.5 ± 8.6	82.4 ± 57.8
Group D	112.6 ± 27.1^a	47.1 ± 14.8^a	58.3 ± 7.5^a	89.3 ± 45.3	105.6 ± 31.6	40.1 ± 14.0	62.1 ± 5.6	83.1 ± 42.1

^aP < 0.05.

HM-NE: HeartModel without regional endocardial border editing; HM-RE: HeartModel with regional endocardial border editing; LVEDV: Left ventricular end-diastolic volume; LVESV: Left ventricular end-systolic volume; LVEF: Left ventricular ejection fraction; LAESV: Left atrial end-systolic volume.

Table 3 Comparison of left ventricular volume and left ventricular ejection fraction measured by M-mode echocardiography, Biplane Simpson, and HeartModel methods against advanced cardiac three-dimensional quantification

Parameter	*r_s*	Bias ± LOA	Relative bias (%)	Percentage error (%)
Teichholz (n = 150)
LVEDV (mL)	0.82	37.3 ± 82.7	35.1	66.1
LVESV (mL)	0.91	20.0 ± 56.2	35.8	85.2
LVEF (%)	0.89	1.5 ± 12.3	3.0	23.5
Biplane Simpson (n = 150)
LVEDV (mL)	0.87	4.6 ± 46.8	4.3	43.0
LVESV (mL)	0.94	1.9 ± 26.9	3.4	47.2
LVEF (%)	0.91	1.4 ± 11.8	2.7	22.6
LAESV (mL)	0.93	0.7 ± 23.7	1.2	39.6
3DQ (n = 150)
LVEDV (mL)	0.96	2.4 ± 21.3	2.3	19.8
LVESV (mL)	0.98	1.3 ± 11.2	2.3	19.8
LVEF (%)	0.98	0.1 ± 5.2	0.2	10.1
HM-NE (n = 150)
LVEDV (mL)	0.85	33.4 ± 56.4	31.4	45.8
LVESV (mL)	0.90	15.7 ± 33.0	28.0	51.6
LVEF (%)	0.85	-0.2 ± 16.8	-0.4	-32.5
LAESV (mL)	0.93	10.2 ± 30.3	17.2	47.0
HM-RE (n = 150)
LVEDV (mL)	0.91	28.1 ± 47.6	26.4	39.5
LVESV (mL)	0.93	14.92 ± 30.9	26.6	48.7
LVEF (%)	0.95	-0.0 ± 9.8	-0.0	-19.0
LAESV (mL)	0.95	8.1 ± 23.7	13.7	37.4

Relative bias = (parametermethod-parameter 3DQA)/parametermethod; Percentage error = LOA/mean value of parameter measured by studied method and 3DQA. LOA: Limits of agreement; 3DQA: Advanced cardiac three-dimensional quantification; 3DQ: Cardiac three-dimensional quantification; HM-NE: HeartModel without regional endocardial border editing; HM-RE: HeartModel with regional endocardial border editing; LVEDV: Left ventricular end-diastolic volume; LVESV: Left ventricular end-systolic volume; LVEF: Left ventricular ejection fraction; LAESV: Left atrial end-systolic volume; DCM: Dilated cardiomyopathy; SWMA: Segmental wall motion abnormality; HCM: Hypertrophic cardiomyopathy.

Table 4 Comparison of left ventricular volume and left ventricular ejection fraction measured by HeartModel with regional endocardial border editing and advanced cardiac three-dimensional quantification in 4 groups (mean ± SD)

Parameter	HM-RE	3DQA	*r_s*	Bias ± LOA	Relative bias (%)	Percentage error (%)
Group A (control group, n = 42)
LVEDV (mL)	86.3 ± 15.9a	77.5 ± 13.7	0.82	8.8 ± 16.1	11.3	10.7
LVESV (mL)	29.6 ± 6.4^a	25.7 ± 5.3	0.85	3.8 ± 5.5	15.1	14.0
LVEF (%)	65.5 ± 3.9a	66.6 ± 4.3	0.96	-1.0 ± 2.4	-1.5	-1.5
LAESV (mL)	39.8 ± 10.6^a	36.8 ± 9.6	0.97	2.9 ± 3.9	8.1	7.7
Group B (DCM, n = 35)
LVEDV (mL)	186.1 ± 45.8^a	147.4 ± 34.7	0.83	38.6 ± 45.7	26.2	23.1
LVESV (mL)	119.6 ± 40.4^a	96.6 ± 30.0	0.86	23.0 ± 39.6	23.8	21.3
LVEF (%)	35.9 ± 9.4	35.1 ± 9.5	0.71	0.7 ± 12.8	2.2	2.2
LAESV (mL)	69.4 ± 33.1^a	60.4 ± 26.5	0.92	7.5 ± 27.7	12.5	11.8
Group C (SWMA, n = 41)
LVEDV (mL)	162.5 ± 56.9^a	121.4 ± 50.8	0.90	41.0 ± 46.7	33.8	28.9
LVESV (mL)	95.5 ± 40.2^a	74.2 ± 35.6	0.90	21.3 ± 31.0	28.7	25.1
LVEF (%)	42.5 ± 8.6^a	40.0 ± 10.2	0.80	2.5 ± 11.0	6.2	6.0
LAESV (mL)	82.4 ± 57.8^a	73.2 ± 51.0	0.89	9.2 ± 25.7	12.6	11.9
Group D (HCM, n = 32)
LVEDV (mL)	105.6 ± 31.6^a	80.0 ± 21.5	0.54	25.5 ± 46.4	31.9	27.5
LVESV (mL)	40.1 ± 14.0^a	27.8 ± 8.7	0.48	12.3 ± 20.9	26.1	36.2
LVEF (%)	62.1 ± 5.6^a	65.1 ± 5.6	0.78	-2.9 ± 6.5	-5.0	-4.6
LAESV (mL)	83.1 ± 42.1^a	70.4 ± 30.5	0.98	12.7 ± 31.1	18.1	16.6

^aP < 0.05.

Relative bias = (parametermethod-parameter 3DQA)/parametermethod; percentage error = LOA/mean value of parameter measured by studied method and 3DQA. 3DQA: Advanced cardiac three-dimensional quantification; LOA: Limits of agreement; HM-RE: HeartModel with regional endocardial border editing; LVEDV: Left ventricular end-diastolic volume; LVESV: Left ventricular end-systolic volume; LVEF: Left ventricular ejection fraction; LAESV: Left atrial end-systolic volume; DCM: Dilated cardiomyopathy; SWMA: Segmental wall motion abnormality; HCM: Hypertrophic cardiomyopathy.

Table 5 Intraobserver, and interobserver variability (coefficient of variation) for the HeartModel with regional endocardial border editing in 4 Groups (mean ± SD)

Group	Intraobserver (%)				Interobserver (%)
Group	LVEDV (mL)	LVESV (mL)	LVEF (%)	LAESV (mL)	LVEDV (mL)	LVESV (mL)	LVEF (%)	LAESV (mL)
Group A	6.6 ± 5.6	11.1 ± 10.4	4.2 ± 3.8	5.8 ± 5.5	6.7 ± 3.8	11.3 ± 7.4	4.2 ± 2.1	7.2 ± 6.0
Group B	6.6 ± 5.1	10.2 ± 4.9	8.4 ± 9.4	8.4 ± 5.1	7.8 ± 3.2	10.4 ± 5.2	8.7 ± 6.3	8.5 ± 4.8
Group C	9.1 ± 7.5	10.2 ± 7.3	7.9 ± 11.9	7.2 ± 7.3	9.4 ± 5.8	10.2 ± 7.1	8.2 ± 6.2	8.1 ± 6.0
Group D	10.3 ± 4.6	14.9 ± 5.2	7.1 ± 1.7	7.5 ± 5.7	17.1 ± 7.6	20.1 ± 7.4	7.8 ± 5.1	7.7 ± 5.1

LVEDV: Left ventricular end-diastolic volume; LVESV: Left ventricular end-systolic volume; LVEF: Left ventricular ejection fraction; LAESV: Left atrial end-systolic volume.

Citation: Pan CK, Zhao BW, Zhang XX, Pan M, Mao YK, Yang Y. Three-dimensional echocardiographic assessment of left ventricular volume in different heart diseases using a fully automated quantification software. World J Clin Cases 2022; 10(13): 4050-4063
URL: https://www.wjgnet.com/2307-8960/full/v10/i13/4050.htm
DOI: https://dx.doi.org/10.12998/wjcc.v10.i13.4050