Clinical Application of a 3-Dimensional Echocardiographic Automated Adaptive Analytics Algorithm to Quantify Left Heart Chamber Size and Function: Experience of a Single Tertiary Referral Centre in Western Sydney

Abstract

Background: Current guidelines recommend the use of three-dimensional echocardiography for the quantification of left heart chamber size and function. However, a number of barriers, including the complexity and time-consuming nature of the analysis, prevent application of 3D echo techniques into routine clinical practice. We examined the utility of a recently validated automated algorithm that measures left atrial (LAV) and left ventricular (LV) volumes and ejection fraction in a busy clinical laboratory and compared this to standard 2D techniques; examining the accuracy and reproducibility of these measurements. Methods: 100 randomly selected patients (64 ± 16.3 years; 61% male) presenting for a transthoracic echo in our clinical service, and representing a range of left ventricular systolic function from normal to severe impairment (median LVEF 59%; minimum 11%, maximum 69%) were examined. 3D measurements of ventricular ejection fraction (LVEF), left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), LAV and stroke volume (SV) using the Philips HeartModel algorithm were compared to measurements using standard 2D techniques. Results: There was excellent correlation between 3D measurements of LVEF, LVEDV, LVESV, LAV and standard 2D measurements. Correlation between SV measured by 3D compared to 2D Doppler and volumetric methods were not as strong, with volumetric method showing better correlation. 3D measurements also showed good reproducibility for all measures. Conclusion: Our results demonstrate the feasibility of using the HeartModel 3D Automated Adaptive Analytics Algorithm as an accurate, reproducible and efficient method to quantify left heart chamber size and systolic function in a busy clinical service.Tabled 1Correlation coefficient (r)95% Confidence IntervalSignificance(p value)LVEF (%)0.920.88–0.95<0.0001LVEDV (ml)0.910.87–0.94<0.0001LVESV (ml)0.940.92–0.96<0.0001LAV (ml)0.940.92–0.96<0.0001SV by Doppler method (ml)0.530.37–0.66<0.0001SV by volumetric method (ml)0.760.66–0.83<0.0001 Open table in a new tab