Analysis of global systolic and diastolic left ventricular performance using volume-time curves by real-time three-dimensional echocardiography

Ziad Zeidan, Raimund Erbel, Joerg Barkhausen, Peter Hunold, Thomas Bartel, Thomas Buck*

*Corresponding author for this work
92 Citations (Scopus)


Background: Left ventricular (LV) volume-time curves (VTC) have been described to provide quantitative data on the dynamics of global LV performance beyond ejection fraction. However, generation of VTCs by conventional 2-dimensional imaging techniques is inherently limited because of inaccurate geometric volume assumptions. We, therefore, studied whether the new concept of volumetric scanning as realized by real-time 3-dimensional echocardiography (RT-3DE) can be used to provide accurate VTCs. Methods: In 30 healthy participants, VTCs were generated from 18 to 24 absolute LV volumes per second by transthoracic RT-3DE and compared with magnetic resonance imaging (MRI) used for reference. LVs were traced manually in 9 to 11 parallel, short-axis planes and volumes calculated by disk method. From VTCs, we determined peak ejection rate (PER), peak early filling rate (PFR), time to PER and PFR, and end-diastolic and end-systolic volumes. For initial clinical application, 2 patient groups of coronary (n = 15) and hypertensive heart disease (n= 16) were studied. Results: In healthy participants, VTCs agreed with MRI (mean errors: PER, -39 ± 67 mL/s; PFR, -18 ± 84 mL/s; time to PER, 8 ± 21 milliseconds; time to PFR 4 ± 18 milliseconds [not significant vs 0]) whereas VTCs in coronary and hypertensive groups revealed significantly impaired diastolic function. Scanning time for VTCs was only 1 to 2 minutes by RT-3DE and 8 ± 2 minutes by MRI (P < .001) and time for offline analysis was 22 ± 5 minutes versus 24 ± 4 minutes by MRI (not significant). Conclusions: Generation of VTCs by RT-3DE is feasible and shows excellent agreement with MRI used for reference. Thus, VTCs by RT-3DE is a promising new approach providing access to quantitative information on global LV performance such as LV filling rates that is currently unavailable for the cardiologist.

Original languageEnglish
JournalJournal of the American Society of Echocardiography
Issue number1
Pages (from-to)29-37
Number of pages9
Publication statusPublished - 01.01.2003


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