FEASIBILITY OF REAL-TIME THREE-DIMENSIONAL ECHOCARDIOGRAPHY FOR THE ASSESSMENT OF DISTORTED BIVENTRICULAR SYSTOLIC FUNCTION IN PATIENTS WITH COR PULMONALE

Background: This study was to investigate the feasibility of real-time 3-dimensional echocardiography (RT3DE) for the analysis of biventricular ejection fractions and volume measurements in patients with cor pulmonale and the correlations of RT3DE results with 64-slice multi-detector cardiac computed tomography (64-MDCT) results. Methods: This study included a total of 22 patients ($59.3{\pm}16.6$ years of age; 10 males and 12 females) who showed flattening or reverse curvature of the interventricular septum and severe pulmonary hypertension [mean right ventricular (RV) systolic pressure = $66.8{\pm}19.7mmHg$] on 2-dimensional transthoracic echocardiography due to cor pulmonale. Biventricular enddiastolic and end-systolic volumes were measured by RT3DE and 64-MDCT. The severity of D-shaped deformation was evaluated by using left ventricular (LV) eccentricity index (ratio of diameters parallel/perpendicular to the interventricular septum on parasternal short axis images of the papillary muscle level). Results: There were moderate correlations between biventricular volumes measured by RT3DE and 64-MDCT except for LV end-systolic volume ($59.8{\pm}17.1$ vs. $73.2{\pm}20.2mL$, r = 0.652, p = 0.001 for LV end-diastolic volume; $30.6{\pm}9.1$ vs. $30.8{\pm}12.5mL$, r = 0.361, p = 0.099 for LV end-systolic volume; $110.1{\pm}42.9$ vs. $171.1{\pm}55.3mL$, r = 0.545, p = 0.009 for RV enddiastolic volume; and $80.9{\pm}35.0$ vs. ${128.7\pm}45.1mL$, r = 0.549, p = 0.005 for RV end-systolic volume respectively). Conclusion: This study suggests that RT3DE may be a modest method for measuring distorted biventricular end-systolic and end-diastolic volumes in patients with cor pulmonale.