The Use of Real Time Three Dimensional Echocardiography in Assessment of Regional Wall Motion Abnormalities in Comparison to Two Dimensional Echocardiography: Validated by Coronary Angiography
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- Category: Vol. 80, June 2012
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The Use of Real Time Three Dimensional Echocardiography in Assessment of Regional Wall Motion Abnormalities in Comparison to Two Dimensional Echocardiography: Validated by Coronary Angiography,DOAA A. FOUAD, AYMAN M. ASHAM and NADIA M. SELIM
Abstract
Background: Real-time three-dimensional echocardio-graphy (RT3DE) is a novel imaging technique that offers a rapid acquisition with multiple simultaneous views of the left ventricle (LV). These features make it more attractive than the subjective two-dimensional echocardiography (2DE) visual method for assessment of regional wall motion abnormalities (RWMA).
Aim of Work: We aimed to evaluate a new semi-automatic assessment of RWMA based on parametric imaging (PI) of RT3DE compared to traditional visual assessment of 2DE, and validated by coronary angiography.
Methods: The study included 100 myocardial infarction (MI) patients having STMI and NSTMI. RWMA were assessed by both conventional 2DE and PI of RT3DE according to the 17 segment LV model. Coronary angiography was performed for all patients and the angiographic data was used as the gold standard to compare the diagnostic ability of both methods for RWMA detection.
Results: There was a good agreement between PI of RT3DE and 2DE in assessment of RWMA of all 5 segments supplied by LCX, 5 of 7 segments supplied by LAD, and 3 of 5 segments supplied by RCA.
Sensitivity of RT3DE was significantly higher than 2DE (60.71% vs 47.32%, p=0.001) for detection of RWMA in LAD lesions, while modest non-significantly higher RT3DE
Abbreviations:
CAD : Coronary artery disease.
NSTMI : Non-ST elevation myocardial infarction. PI : Parametric imaging.
RT3DE : Real-time three-dimensional echocardiography. RWMA : Regional wall motion abnormalities.
STMI : ST-elevation myocardial infarction.
WMSI : Wall motion score index.
2DE : Two-dimensional echocardiography.
sensitivity was detected in LCX and RCA lesions (66.33% vs 54.00%, p=0.074) and (62.77% vs 53.88%, p=0.140) respec-tively. There was no significant difference between RT3DE and 2DE specificity for LAD, LCX, and RCA lesions (89.68% vs 90.07%, p=0.865), (87.42% vs 89.14%, p=0.063) and (79.06% vs 80.62%, p=0.568) respectively.
Sensitivity of RT3DE for correct identification of increased WMSI was significantly higher than 2DE in NSTMI (p=0.031) and was near significant in STMI patients (p=0.063).
Conclusion: Parametric imaging of RT3DE can be used for assessment of RWMA with good agreement to visual assessment of conventional 2DE. Compared to 2DE, RT3DE has better sensitivity to detect RWMA in segments supplied with LAD. It has also better sensitivity than 2DE in assessment of WMSI in patients with NSTMI.