St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.
Hospital Santa Cruz, Lisboa, Portugal.
Eur Heart J Cardiovasc Imaging. 2024 Jan 29;25(2):278-284. doi: 10.1093/ehjci/jead245.
The accuracy and reproducibility of echocardiography to quantify left ventricular ejection fraction (LVEF) is limited due to image quality. High-definition blood flow imaging is a new technique which improves cavity delineation without the need for medication or intravenous access. We sought to examine the impact of high-definition blood flow imaging on accuracy and reproducibility of LV systolic function assessment.
Prospective observational study of consecutive patients undergoing 2D and 3D transthoracic echocardiography (TTE), high-definition blood flow imaging, and cardiac magnetic resonance (CMR) within 1 h of each other. Left ventricular systolic function characterized by left ventricular end-systolic volumes and left ventricular end-diastolic volumes and LVEF were measured. Seventy-six patients were included. Correlation of 2D TTE with CMR was modest (r = 0.68) with a worse correlation in patients with three or more segments not visualized (r = 0.58). High-definition blood flow imaging was feasible in all patients, and the correlation of LVEF with CMR was excellent (r = 0.88). The differences between 2D, high-definition blood flow, and 3D TTE compared to CMR were 5 ± 9%, 2 ± 5%, and 1 ± 3%, respectively. The proportion of patients where the grade of LV function was correctly classified improved from 72.3% using 2D TTE to 92.8% using high-definition blood flow imaging. 3D TTE also had excellent correlation with CMR (r = 0.97) however was only feasible in 72.4% of patients.
High-definition blood flow imaging is highly feasible and significantly improves the diagnostic accuracy and grading of LV function compared to 2D echocardiography.
由于图像质量的限制，超声心动图定量左心室射血分数（LVEF）的准确性和可重复性受到限制。高清血流成像是一种新技术，它可以在不需要药物或静脉通路的情况下改善腔的描绘。我们旨在研究高清血流成像对左心室收缩功能评估的准确性和可重复性的影响。
这是一项连续患者的前瞻性观察研究，这些患者在彼此 1 小时内接受了 2D 和 3D 经胸超声心动图（TTE）、高清血流成像和心脏磁共振（CMR）检查。测量了左心室收缩功能的特征，包括左心室收缩末期容积和左心室舒张末期容积以及 LVEF。共纳入 76 例患者。2D TTE 与 CMR 的相关性中等（r = 0.68），在三个或更多节段不可见的患者中相关性更差（r = 0.58）。高清血流成像在所有患者中均可行，与 CMR 的相关性非常好（r = 0.88）。与 CMR 相比，2D、高清血流和 3D TTE 的 LVEF 差异分别为 5 ± 9%、2 ± 5%和 1 ± 3%。使用 2D TTE 时，正确分类 LV 功能分级的患者比例为 72.3%，而使用高清血流成像时则提高至 92.8%。3D TTE 与 CMR 也具有极好的相关性（r = 0.97），但仅在 72.4%的患者中可行。
与 2D 超声心动图相比，高清血流成像高度可行，可显著提高 LV 功能的诊断准确性和分级。
