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(Circulation. 2008;117:1842-1848.)
© 2008 American Heart Association, Inc.

Imaging

Matrix-Array 3-Dimensional Echocardiographic Assessment of Volumes, Mass, and Ejection Fraction in Young Pediatric Patients With a Functional Single Ventricle

A Comparison Study With Cardiac Magnetic Resonance

Brian D. Soriano, MD; Martin Hoch, MD; Alejandro Ithuralde, MD; Tal Geva, MD; Andrew J. Powell, MD; Barry D. Kussman, MBBCh; Dionne A. Graham, PhD; Wayne Tworetzky, MD; Gerald R. Marx, MD

From the Departments of Cardiology (B.D.S., M.H., A.I., T.G., A.J.P., D.A.G., W.T., G.R.M.) and Anesthesiology (B.D.K.), Children’s Hospital Boston, Boston, Mass, and the Departments of Pediatrics (B.D.S., M.H., A.I., T.G., A.J.P., D.A.G., W.T., G.R.M.) and Anaesthesia (B.D.K.), Harvard Medical School, Boston, Mass.

Correspondence to Gerald R. Marx, MD, Children’s Hospital Boston, 300 Longwood Ave, FA-218, Boston, MA 02115. E-mail gerald.marx{at}cardio chboston.org

Received May 18, 2007; accepted February 5, 2008.

Background— Quantitative assessment of ventricular volumes and mass in pediatric patients with single-ventricle physiology would aid clinical management, but it is difficult to obtain with 2-dimensional echocardiography. The purpose of the present study was to compare matrix-array 3-dimensional echocardiography (3DE) measurements of single-ventricle volumes, mass, and ejection fraction with those measured by cardiac magnetic resonance (CMR) in young patients.

Methods and Results— Twenty-nine patients (median age, 7 months) with a functional single ventricle undergoing CMR under general anesthesia were prospectively enrolled. The 3DE images were acquired at the conclusion of the CMR. Twenty-seven of 29 3DE data sets (93%) were optimal for 3DE assessment. Two blinded and independent observers performed 3DE measurements of volume, mass, and ejection fraction. The 3DE end-diastolic volume correlated well (r=0.96) but was smaller than CMR by 9% (P<0.01), and 3DE ejection fraction was smaller than CMR by 11% (P<0.01). There was no significant difference in measurements of end-systolic volume and mass. The 3DE interobserver differences for mass and volumes were not significant except for ejection fraction (8% difference; P<0.05). Intraobserver differences were not significant.

Conclusions— In young pediatric patients with a functional single ventricle, matrix-array 3DE measurements of mass and volumes compare well with those obtained by CMR. 3DE will provide an important modality for the serial analysis of ventricular size and performance in young patients with functional single ventricles.

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CLINICAL PERSPECTIVE

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Clinical Summaries
Circulation 2008 117: 1769. [Full Text]