Abstract 1852: Left Ventricular Wall Motion Analysis: Are Current Generations of 3D Echocardiography Technology Adequate Substitutes for 2D Imaging?
Background 3D echo has theoretical advantages for wall motion analysis including decreased acquisition time and improved flexibility regarding apical and short axis imaging. While prior studies have demonstrated feasibility in carefully selected populations, we hypothesized that the current generation of 3D transthoracic echo would allow for adequate analysis of all LV segments in a general cardiology population and that this could be obtained and reviewed in a reasonable time frame.
Methods 50 patients were recruited from our clinical echo lab for a non-contrast 2D and 3D echo (Philips 7500, X4 transducer). Patient characteristics: age 62±18,42% female, BMI 28±5, LVEF 63%±7%, Afib 12%. Based on lab indication for contrast, patient with ≥ 2 contiguous non-visualized segments on 2D were excluded. 3D full volume acquisitions were obtained from the apical and parasternal view. Wall motion on 2D and 3D was separately scored (16 segment model) by consensus from 2 readers on de-identified images in random order.
Results A total of 1600 segments were reviewed. Both 2D and 3D allowed for visualization of an endocardial border in > 90% of segments; however, there remains a small but significant benefit to 2D imaging (94% (752) v. 99% (795) out of 800 segments in each group, p<0.001). In addition, it was noted that a more complete set of wall motion analysis was obtained when parasternal 3D images were combined with the apical view compared to apical view alone (94% v. 88%, p<0.001). With regards to wall motion score, 2D and 3D analysis had concordant findings in 99% of visualized segments (61 segments coded abnormal). Post-acquisition review and processing of the 3D data averaged 11 ± 4 minutes per patient.
Conclusions This study demonstrates that 3D imaging is capable of visualizing up to 94% of wall segments as compared to 99% for 2D and that the wall motion score among visualized segments is highly concordant. Full volume acquisitions from 2 locations (apical and parasternal) appears to improve 3D wall motion analysis and this interpretation can often be performed in a reasonable time frame. Although 2D imaging continues to remain an echocardiographic standard for wall motion, 3D may be able to offer unique advantages in the near future.