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Research Article
Diogo Rodrigues Brás
Hospital Espirito Santo Evora
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3327-5054
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This work is licensed under a CC BY 4.0 License. Read Full License
Purpose: The Biplane Simpson (BPS) remains the recommended 2-dimensional method to assess left ventricular ejection fraction (LVEF). However, it has known limitations that may be overcome with 3D real-time triplane (RTTP), for instance, obtaining all apical views simultaneously at the same cardiac cycle. Accurate LVEF measurement is of utmost importance, as it guides the allocation of many treatments that reduce morbidity and mortality in heart failure. We sought to compare LVEF and volumes assessed by BPS and RTTP, using 3D LV full volume as reference, in patients with ST-segment elevation myocardial infarction (STEMI).
Methods and results: Prospective study that included consecutive STEMI patients. LV volumes and EF were compared between BPS and RTTP and the reference method. Fifty-two patients were studied and anterior MI was the most frequent location (44%). There was strong correlation between EF measured by BPS (r=0.80, p<0.001) and RTTP (r=0.91, p<0.001) versus the reference method, with significant difference between coefficients (0.11, p=0.034). EF by BPS attained a good inter-operator agreement, with an intraclass correlation (ICC) of 0.82 (95% CI 0.710-0.894,p<0.001), as well as EF by RTTP (ICC 0.88, 95% CI 0.801–0.930,p<0.001), without statistically significant difference between the two methods (p=0.279).
Conclusion: Estimation of LV volumes and EF by RTTP method showed higher correlation than BPS with 3D-echocardiography, in a population of STEMI patients. As an accurate LVEF estimation is of high relevance for its potential to alter clinical decision pathways, this data points to the usefulness of the RTTP method, especially in myocardial infarction setting.
Keywords
3D Echocardiography, Real-time triplane, LV ejection fraction, ST-segment elevation myocardial infarction
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research Article
Diogo Rodrigues Brás
Hospital Espirito Santo Evora
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3327-5054
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 30 Mar, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Purpose: The Biplane Simpson (BPS) remains the recommended 2-dimensional method to assess left ventricular ejection fraction (LVEF). However, it has known limitations that may be overcome with 3D real-time triplane (RTTP), for instance, obtaining all apical views simultaneously at the same cardiac cycle. Accurate LVEF measurement is of utmost importance, as it guides the allocation of many treatments that reduce morbidity and mortality in heart failure. We sought to compare LVEF and volumes assessed by BPS and RTTP, using 3D LV full volume as reference, in patients with ST-segment elevation myocardial infarction (STEMI).
Methods and results: Prospective study that included consecutive STEMI patients. LV volumes and EF were compared between BPS and RTTP and the reference method. Fifty-two patients were studied and anterior MI was the most frequent location (44%). There was strong correlation between EF measured by BPS (r=0.80, p<0.001) and RTTP (r=0.91, p<0.001) versus the reference method, with significant difference between coefficients (0.11, p=0.034). EF by BPS attained a good inter-operator agreement, with an intraclass correlation (ICC) of 0.82 (95% CI 0.710-0.894,p<0.001), as well as EF by RTTP (ICC 0.88, 95% CI 0.801–0.930,p<0.001), without statistically significant difference between the two methods (p=0.279).
Conclusion: Estimation of LV volumes and EF by RTTP method showed higher correlation than BPS with 3D-echocardiography, in a population of STEMI patients. As an accurate LVEF estimation is of high relevance for its potential to alter clinical decision pathways, this data points to the usefulness of the RTTP method, especially in myocardial infarction setting.
Figure 1
Figure 2
Figure 3
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