Availability of Semi-automatic Measurements of Left Ventricular Volume and Ejection Fraction by 2D and 3D Echocardiography

Background: Recently tracking-based echocardiographic ejection fraction (EF) assessment (AutoEF) has been introduced. In addition, recent advances make it possible to quantify the left ventricular (LV) volume in its three-dimensional perspective (3DEF). This study was designed to evaluate the accuracy and reproducibility of these novel semi-automatic measurements using the traditional biplane Modified Simpson method (Simpson) as a reference. Methods: 46 patients (63±12 years old, 37 men, 29 patients represented a LV regional functional abnormalities) in sinus rhythm underwent 2D and 3D echocardiography on Vivid E9 (GE Healthcare, Horten, Norway). LV end-diastolic volume, end-systolic volume, and EF were measured by the four methods: bp-MOD, AutoEF, AutoEF corrected by a user interaction (Interacted AutoEF) and 3DEF. Inter- and intra-observer variability for each method was investigated. Added to this, the accuracy of AutoEF, Interacted AutoEF and 3DEF were compared with that of bp-MOD. Time for each measurement was also documented. Results: AutoEF demonstrated a higher throughput with good reproducibility. However, it tended to assess LV volume smaller than reference, especially on the patients with wall motion abnormalities and/or possible dilated cardiomyopathy. Agreement between Interacted AutoEF and bp-MOD was much better than the Auto EF with the addition of still time saving compared to bp-MOD. 3DEF was also a rapid and robust method, but was not so accurate compared with bp-MOD. Furthermore, the feasibility of 3DEF is limited because of the necessity to use another dedicated probe for 3D echocardiography. Conclusions: AutoEF with manual interaction is a very robust and helpful method to assess EF in routine clinical practice. 3DEF is also a valuable tool, however, there is still room for improvement such as smaller probe and easier operation.