Pan CK, Zhao BW, Zhang XX, Pan M, Mao YK, Yang Y. Three-dimensional echocardiographic assessment of left ventricular volume in different heart diseases using a fully automated quantification software. World J Clin Cases 2022; 10(13): 4050-4063 [PMID: 35665130 DOI: 10.12998/wjcc.v10.i13.4050]
Corresponding Author of This Article
Bo-Wen Zhao, MD, Chief Doctor, Professor, Department of Diagnostic Ultrasound and Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, No. 3 East Qingchun Road, Hangzhou 310016, Zhejiang Province, China. zbwcjp@zju.edu.cn
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 6, 2022; 10(13): 4050-4063 Published online May 6, 2022. doi: 10.12998/wjcc.v10.i13.4050
Three-dimensional echocardiographic assessment of left ventricular volume in different heart diseases using a fully automated quantification software
Chen-Ke Pan, Bo-Wen Zhao, Xuan-Xuan Zhang, Mei Pan, Yan-Kai Mao, Yuan Yang
Chen-Ke Pan, Bo-Wen Zhao, Mei Pan, Yan-Kai Mao, Yuan Yang, Department of Diagnostic Ultrasound and Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou 310016, Zhejiang Province, China
Chen-Ke Pan, Xuan-Xuan Zhang, Department of Ultrasound, The Fourth Affiliated Hospital of Zhejiang University College of Medicine, Yiwu 322200, Zhejiang Province, China
Author contributions: Pan CK collected and analyzed the data, wrote the paper; Zhao BW designed and oversight the study; Zhang XX assisted with data analysis; Pan M, Mao YK and Yang Y was involved with data collection; all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Boards of Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University Ethics Committee in China (No. KY20200210-78).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo-Wen Zhao, MD, Chief Doctor, Professor, Department of Diagnostic Ultrasound and Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, No. 3 East Qingchun Road, Hangzhou 310016, Zhejiang Province, China. zbwcjp@zju.edu.cn
Received: September 3, 2021 Peer-review started: September 3, 2021 First decision: December 1, 2021 Revised: December 10, 2021 Accepted: March 14, 2022 Article in press: March 14, 2022 Published online: May 6, 2022
Abstract
BACKGROUND
HeartModel (HM) is a fully automated adaptive quantification software that can quickly quantify left heart volume and left ventricular function. This study used HM to quantify the left ventricular end-diastolic (LVEDV) and end-systolic volumes (LVESV) of patients with dilated cardiomyopathy (DCM), coronary artery heart disease with segmental wall motion abnormality, and hypertrophic cardiomyopathy (HCM) to determine whether there were differences in the feasibility, accuracy, and repeatability of measuring the LVEDV, LVESV, LV ejection fraction (LVEF) and left atrial end-systolic volume (LAESV) and to compare these measurements with those obtained with traditional two-dimensional (2D) and three-dimensional (3D) methods.
AIM
To evaluate the application value of HM in quantifying left heart chamber volume and LVEF in clinical patients.
METHODS
A total of 150 subjects who underwent 2D and 3D echocardiography were divided into 4 groups: (1) 42 patients with normal heart shape and function (control group, Group A); (2) 35 patients with DCM (Group B); (3) 41 patients with LV remodeling after acute myocardial infarction (Group C); and (4) 32 patients with HCM (Group D). The LVEDV, LVESV, LVEF and LAESV obtained by HM with (HM-RE) and without regional endocardial border editing (HM-NE) were compared with those measured by traditional 2D/3D echocardiographic methods to assess the correlation, consistency, and repeatability of all methods.
RESULTS
(1) The parameters measured by HM were significantly different among the groups (P < 0.05 for all). Compared with Groups A, C, and D, Group B had higher LVEDV and LVESV (P < 0.05 for all) and lower LVEF (P < 0.05 for all); (2) HM-NE overestimated LVEDV, LVESV, and LAESV with wide biases and underestimated LVEF with a small bias; contour adjustment reduced the biases and limits of agreement (bias: LVEDV, 28.17 mL, LVESV, 14.92 mL, LAESV, 8.18 mL, LVEF, -0.04%). The correlations between HM-RE and advanced cardiac 3D quantification (3DQA) (rs = 0.91-0.95, P < 0.05 for all) were higher than those between HM-NE (rs = 0.85-0.93, P < 0.05 for all) and the traditional 2D methods. The correlations between HM-RE and 3DQA were good for Groups A, B, and C but remained weak for Group D (LVEDV and LVESV, rs = 0.48-0.54, P < 0.05 for all); and (3) The intraobserver and interobserver variability for the HM-RE measurements were low.
CONCLUSION
HM can be used to quantify the LV volume and LVEF in patients with common heart diseases and sufficient image quality. HM with contour editing is highly reproducible and accurate and may be recommended for clinical practice.
Core Tip: This was a prospective international trial with 150 patients seeking to evaluate the accuracy and reproducibility of the fully automated quantification software, HeartModel (HM).The results showed that HM can be used to quantify the left ventricular (LV) volume and LV ejection fraction in patients with common heart diseases and may be recommended for clinical practice.
