Validation of Real-Time 3d Echocardiography Left Ventricular Volume- Time Curves with Cardiac MRI and Clinical Utilization of Emptying and Filling Rates

Background: 3D echocardiography derived volumetric data can be used to generate left ventricular volume time curves and has the potential to elucidate aspects of contractility, systolic and diastolic function in normal and disease states. We sought to establish the validity and reproducibility of these volume-time curves and apply novel parameters derived from these curves to a clinical population. Methods: Consecutive patients, who underwent cardiac MRI and echocardiography within 12 hours, were used to compare volume-time curves. Inter- and intra observer variability of the 3D echocardiography volume-time curves was assessed. Peak emptying rates, peak filling rates, and peak systolic acceleration were measured in a normal population (normal Ejection Fraction (EF) and no significant valvular disease) and their change with age was evaluated. Results: 16 patients with an average EF of 55% ± 10% underwent cardiac MRI and 3D echocardiography. Therewas no significant difference between the systolic and diastolic slopes of the volume-time curves derived by the two methods with good correlation for both systole (r=0.62, p < 0.0001) and diastole (r=0.43, p=0.0025). In 50 normal patients aged 19-91, peak emptying rate, peak filling rate, and peak systolic acceleration all decreased with age. Conclusion: 3D echocardiography volume-time curves correlate well with the gold standard of cardiac MRI. The novel 3D parameters of peak emptying rate, peak filling rate, and peak systolic acceleration may prove to be helpful in the assessment of systolic and diastolic function and provide insight into ventricular performance.