Physicians can better predict potentially life-threatening cardiac events with real-time, 3D echocardiography, according to a study presented at the American Society of Echocardiography (ASE) meeting in Washington, D.C.
"Three-dimensional echocardiography addresses some of the limitations that exist in two-dimensional echo," said the study's lead author, Carly Jenkins, MD, of the University of Queensland in Woolloongabba, Australia.
Physicians can use echocardiograms to view the heart's left ventricular end systolic volume and ejection fraction, which can help determine the severity of the patient's heart condition. Left ventricular end systolic volume measured by 2D echocardiography is an important correlate of survival, the researchers reported. They sought to determine whether 3D echo was more predictive of outcome than 2D echo. The study included 535 patients referred for left ventricle assessment. Patients underwent assessment with 2D and 3D echocardiography.
Over four to five years, cardiac admission, incident heart failure and atrial fibrillation and all-cause mortality information was obtained in 461 of 504 patients with images suitable for measurement. The results showed 48 cardiac events (10 percent), including 34 deaths. The investigators noted that larger left ventricular end-systolic volume and lower ejection fraction were associated with worse outcome.
They concluded that the addition of 2D echo end-systolic volume increased the association of clinical variables (renal disease, left ventricular impairment and age) with outcome, but 3D echo end-systolic volume increased the strength of association. Similarly, the incremental value of 2D echo ejection fraction was exceeded by 3D echo ejection fraction.
On the basis of the study results, the investigators concluded that 3D measurements could help guide management decisions on how to best treat the patient and therefore, better predict the patient's chance of survival.
"This study proves that 3D technology has a better diagnostic value for predicting patient outcomes with regard to left ventricular volume and ejection fraction," Jenkins said. "By using the newer technology, physicians can make better decisions about patient management."