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Most biplane methods for the echocardiographic calculation of left ventricular volumes assume orthogonality between paired views from the apical window. Our aim was to study the accuracy of biplane left ventricular volume calculations when either the apical two-chamber or long-axis views are combined with the four-chamber view. The left ventricular volumes calculated from three-dimensional echocardiographic data sets were used as a reference. Twenty-seven patients underwent precordial three-dimensional echocardiography using rotational acquisition of planes at 2-degree intervals, with ECG and respiratory gating. End-diastolic and end-systolic left ventricular volumes and ejection fraction on three-dimensional echocardiography were calculated by (1) Simpson's methods (3DS) at 3 mm short-axis slice thickness (reference method) and by (2) biplane ellipse from paired views using either apical four- and two-chamber views (BE-A) or apical four- and long-axis views (BE-B). Observer variabilities were studied by the standard error of the estimate % (SEE) in 19 patients for all methods.

european heart journal

The apical long-axis rather than the two-chamber view should be used in combination with the four-chamber view for accurate assessment of left ventricular volumes and function