Left ventricular mass assessed by three‐dimensional echocardiography using rotational acquisition

Background : The reproducibility of left ventricular (LV) mass measurement by two‐dimensional (2‐D) echocardiography is inadequate for individual assessments. Hypothesis : This study was undertaken to evaluate the potential of LV mass determination with a new three‐dimensional (3‐D) echocardiographic method compared with 2‐D measurement. Methods : Porcine agarose‐filled left ventricles (n = 15, true mass 61–511 g) of different shapes were measured by a multiplane 3‐D method based on 90 images acquired by probe rotation axis (1) perpendicular and (2) parallel to the ventricular long axis [“parasternal” (the left sternal border was not present as a reference point in this study) and apical views]. Mass was also obtained using (3) the biplane truncated ellipsoid and (4) area‐length methods, as well as (5) the modified cube formula. Five hearts were not analyzed with the apical 3‐D technique because of insufficient image quality. Results : Systematic deviation from true mass was small with all methods (< 5.3%). Accuracy, expressed as 1 standard deviation of individual estimates around this systematic bias, was 7.7, 13.6, 8.2, 11.9, and 11.9% of true mass for the methods 1–5, respectively. Interobserver reproducibility, expressed as the coefficient of variation, was 4.7, 8.8, 8.1, 8.9, and 9.4% for the same methods. Conclusion : Limits for individual accuracy and reproducibility of LV mass estimates are nearly doubled using apical compared with “parasternal” 3‐D echocardiography in vitro. A main advantage of “parasternal” 3‐D compared with 2‐D LV mass estimates is better reproducibility, but at the expense of greater time consumption. Apical 3‐D technique is not superior to simpler 2‐D methods based on “parasternal” short axis imaging.