Left ventricular volume and mass: Comparative study of two-dimensional echocardiography and ultrafast computed tomography

This study was undertaken to define the accuracy of two-dimensional echocardiography in the determination of left ventricular end-diastolic and end-systolic volumes, stroke volume, ejection fraction, and mass when compared to ultrafast cine computed tomography in the same 56 patients. Single-plane and biplane modified Simpson's rule, single-plane and biplane ellipsoidal formula, bullet formula (biplane only), and biapical Simpson's rule methods were utilized. Linear regression analysis showed the strongest correlation with the modified biplane Simpson's rule (mean r = 0.897). In valvular heart disease (n = 12) and dilated cardiomyopathy (n = 6), the mean correlation coefficients for all methods were high (r = 0.894 and 0.911, respectively). The mean correlation coefficient for all methods in patients with prior myocardial infarction (n = 25) was relatively poor (r = 0.643). Intraobserver and interobserver variabilities for all methods were low (r = 0.980 and 0.965, respectively). It is concluded that calculations of left ventricular volumes and mass by two-dimensional echocardiography are accurate and reproducible in patients with a global effect on the left ventricle and were less acceptable in patients with segmental (ischemic) left ventricular involvement. The best measurement technique is a modified biplane Simpson's rule.