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Three‐dimensional echocardiographic comparison of left ventricular geometry and systolic function between dilated cardiomyopathy and mitral regurgitation with similar left ventricular dilation
Author(s) -
Zeng DeCai,
Wu Ji,
Wu ShuiShun,
Lin HaiHong,
Chen Hui
Publication year - 2020
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22775
Subject(s) - medicine , cardiology , dilated cardiomyopathy , ejection fraction , mitral regurgitation , receiver operating characteristic , heart failure , dilation (metric space) , functional mitral regurgitation , diastole , blood pressure , geometry , mathematics
Purpose This study aimed to analyze left ventricular (LV) remodeling in patients with LV dilation using three‐dimensional (3D) echocardiography, and to compare geometry and systolic function between patients with dilated cardiomyopathy (DCM) and with mitral regurgitation (MR) but similar LV dimension. Methods Cross‐sectional study of 60 DCM and 60 MR patients with LV end diastolic diameter (LVEDD) > 35 mm/m 2 , and of 60 healthy control volunteers. Results Despite a similar LVEDD, DCM patients showed a significantly higher 3D sphericity index (3D‐SI) than MR patients, whereas 3D ejection fraction (3D‐EF) was significantly lower ( P < .01). There was a linear relationship between 3D‐EF and 3D‐SI in both DCM and MR patients (r = −0. 745 and r = −0. 642, respectively; both P < .001). Receiver operating characteristic (ROC) curves showed that 3D‐SI had could better discriminate between DCM and MR (sensitivity 90%; specificity 73%; AUC 0.852, P < .01) than other variables. The area under the ROC curve of 3D‐SI was significantly larger than that of 3D‐EF for detecting heart failure in both patients with DCM and MR. Conclusions LV geometry appears to be more spherical and associated with worse systolic function in DCM than in MR patients, in spite of similar LV dimensions. Systolic function correlated significantly with 3D‐SI, which provided a better description of LV remodeling and could be a stronger indicator of heart failure in patients with LV dilation.