Three‐Dimensional Echocardiography in the Evaluation of Global and Regional Function in Patients with Recent Myocardial Infarction: A Comparison with Magnetic Resonance Imaging

We aimed to compare three‐dimensional (3 D ) and two‐dimensional (2 D ) echocardiography in the evaluation of patients with recent myocardial infarction ( MI ), using late‐enhancement magnetic resonance imaging ( LE ‐ MRI ) as a reference method. Echocardiography and LE ‐ MRI were performed approximately 1 month after first‐time MI in 58 patients. Echocardiography was also performed on 35 healthy controls. Left ventricular ( LV ) ejection fraction by 3 D echocardiography (3 D ‐ LVEF ), 3 D wall‐motion score ( WMS ), 2 D ‐ WMS , 3 D speckle tracking–based longitudinal, circumferential, transmural and area strain, and 2 D speckle tracking–based longitudinal strain ( LS ) were measured. The global correlations to infarct size by LE ‐ MRI were significantly higher (P < 0.03) for 3 D ‐ WMS and 2 D ‐ WMS compared with 3 D ‐ LVEF and the 4 different measurements of 3 D strain, and 2 D global longitudinal strain ( GLS ) was more closely correlated to LE ‐ MRI than 3 D GLS (P < 0.03). The segmental correlations to infarct size by LE ‐ MRI were also significantly higher (P < 0.04) for 3 D ‐ WMS , 2 D ‐ WMS , and 2 D LS compared with the other indices. Three‐dimensional WMS showed a sensitivity of 76% and a specificity of 72% for identification of LV infarct size >12%, and a sensitivity of 73% and a specificity of 95% for identification of segments with transmural infarct extension. Three‐dimensional WMS and 2 D gray‐scale echocardiography showed the strongest correlations to LE ‐ MRI . The tested 3 D strain method suffers from low temporal and spatial resolution in 3 D acquisitions and added diagnostic value could not be proven.