Quantitative assessment of left ventricular size and function in cardiac transplant recipients: Side‐by‐side comparison of real time two‐dimensional echocardiography, contrast‐enhanced two‐dimensional echocardiography, three‐dimensional echocardiography, and contrast‐enhanced three‐dimensional echocardiography as compared to magnetic resonance imaging

We evaluate the ability of 2D non‐contrast‐enhanced echocardiography ( CE ‐echo), 2 DCE ‐echo, 3D‐echo, 3D non‐ CE ‐echo, and 3 DCE ‐echo to evaluate allograft function and dimensions in orthotropic heart transplantation ( OHT ). Cardiac resonance ( CMR ) was used as reference. Methods Twenty six consecutive OHT ‐recipients were prospectively recruited. Bland–Altman, Spearman rank, and concordance‐correlation coefficients ( CCC ) were determined. Results Good CCC s were found between the four modalities and CMR for ejection fraction ( r  ≥ 0.72/ P  < 0.001; r  ≥ 0.77/ P  < 0.001; r  ≥ 0.51/ P  < 0.23; r  ≥ 0.75/ P  < 0.001, respectively). Highest intraclass correlation coefficient ( ICC ) was for 2D CE ‐echo( CCC  = 0.77). End‐diastolic volume( EDV ) measurements statistically differed when 2D non‐ CE ‐echo, 2 DCE ‐echo, and 3D non‐ CE ‐echo were compared with the cross‐sectional imaging modalities, but they did not differ significantly from 3 DCE ‐echo. End‐systolic volume ( ESV ) and stroke volume ( SV ) differed statistically between the four modalities; however, SV measured by CMR and 3 DCE ‐echo were comparable. Overall, 2D non‐ CE ‐echo, 2 DCE ‐echo, and 3D non‐ CE ‐echo showed lower mean EDV , ESV , and SV than CMR . ICC was that of the ESV variable in the 4 techniques, with the values of the ICC of the 3 DCE ‐echo technique superior to the rest. Overall, the best CCC were found for 3 DCE ( r  = 0.88, 0.92 and 0.76 for EDV , ESV and SV , respectively). Conclusion Routine use of 3 DCE ‐echo may allow more comprehensive cardiac assessment in cardiac transplant recipients.