Comparison of model-based and speckle tracking-based automated three-dimensional echocardiographic quantification of left ventricular volumes and function: A multicenter study

Abstract

Background

Three-dimensional echocardiography (3DE) provides accurate and reproducible measurements of left ventricular (LV) volumes and ejection fraction (LVEF). Speckle tracking-based 4D LV-Analysis and model-based Dynamic Heart Model (DHM) are commonly used automated 3DE software. However, the potential discrepancies in quantification between these two software have not been fully elucidated. Therefore, this study aimed to determine the differences between the two methods.

Methods

A total of 770 healthy individuals aged 18 to 79 years were enrolled in 38 hospitals throughout China. LV volumes and LVEF were measured using both speckle tracking-based 4D LV-Analysis and model-based DHM.

Results

The measurements of LV end-diastolic volume, end-systolic volume, stroke volume, and LVEF by DHM were found to be 16.6 mL, 5.1 mL, 11.6 mL, and 1.0 % higher, respectively, compared with 4D LV-Analysis (all P values were < 0.001). DHM showed shorter analysis time in comparison with 4D LV-Analysis, whether manual adjustment is required or not. Although both methods exhibited high reproducibility, the reproducibility of DHM was less influenced by variations in image quality. Due to the differences between the two software, age- and sex-specific reference ranges for LV volumes and LVEF were established for the DHM.

Conclusion

There are notable differences between DHM and 4D LV-Analysis in LV quantification. Specifically, LV volumes and LVEF measured using DHM are significantly higher. These discrepancies should be carefully considered in clinical practice, and distinct reference ranges should be employed accordingly.