Document Detail


Feasibility and clinical decision-making with 3D echocardiography in routine practice.
MedLine Citation:
PMID:  17664184     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the feasibility and potential impact of routine three-dimensional (3D) echocardiographic assessment of left ventricular (LV) ejection fraction and volumes on clinical decision-making. METHODS: Patients referred to three hospital-based echocardiography laboratories underwent 2D echocardiography (2DE) and 3D echocardiography (3DE). Feasibility was assessed in a group of 168 unselected patients and decision-making assessed within an expanded group of 220 patients. The time for acquisition and measurement was obtained. Feasibility was defined by ability to measure LV parameters. The potential of 3DE to alter clinical decisions based on 2DE was evaluated by the ability to identify four clinically relevant measurement thresholds: (1) LV end-systolic volume (LVESV) >50 ml/m(2) (indication for surgery in regurgitant valve disease); (2) LVESV >30 ml/m(2) (prognosis after infarction); (3) LV ejection fraction (LVEF) <35% (indication for implantable defibrillator); and (4) LVEF <40% (indication for heart failure treatment). RESULTS: 3DE was technically feasible in 83% of unselected patients. The additional time for 3D acquisition and measurement was available in 184 patients and was 5.4 (SD 2.0) minutes. The use of 3DE changed categorisation in between 6-11% of patients. Within threshold categories, 3D reallocated 17.5% (11/63) of patients with LVEF <35%, 16.1% (13/81) for LVEF <40%, 12.4% (13/105) for LVESV >30 ml/m(2) and 8.5% (5/59) for LVESV >50 ml/m(2). Most of the impact of 3D was within 10 ml/m(2) of selected volume thresholds (>or=75%) and 10% of EF thresholds (>80%). CONCLUSION: Measurement of LV volumes and EF by 3DE is clinically feasible and has the potential to significantly alter clinical decision-making.
Authors:
J L Hare; C Jenkins; S Nakatani; A Ogawa; C-M Yu; T H Marwick
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2007-07-30
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  94     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-18     Completed Date:  2008-04-07     Revised Date:  2008-09-05    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  440-5     Citation Subset:  AIM; IM    
Affiliation:
University of Queensland, Brisbane, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Decision Making*
Echocardiography, Three-Dimensional*
Feasibility Studies
Female
Heart Diseases / physiopathology,  therapy,  ultrasonography*
Humans
Male
Middle Aged
Prognosis
Stroke Volume
Ventricular Function, Left
Comments/Corrections
Comment In:
Heart. 2008 Sep;94(9):1123-5   [PMID:  18703692 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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