Two-dimensional echocardiographic automatic boundary detection for evaluation of left ventricular function in unselected adult patients.

Recent modifications in two-dimensional echocardiographic imaging include automatic boundary detection (ABD) that permits instantaneous quantification of left ventricular (LV) function. To define its clinical application from different views in consecutive patients (n = 68), we performed both conventional two-dimensional imaging and ABD with lateral gain compensation and compared the ability of each method for visualization of myocardial segments. From each view (short-axis and apical four- and two-chamber), the LV was divided into six wall segments. The short-axis view was obtained successfully in 53 of 68 patients; of the possible 318 segments, 96% were visualized adequately by two-dimensional echocardiography and 89% by ABD. From the four-chamber view, obtained in 63 of 68 patients, visualization of 378 possible segments was 93% by two-dimensional imaging and 86% by ABD, respectively. From the two-chamber view obtained in 58 of 68 patients, the success rate was 88% and 80% (two-dimensional imaging and ABD, respectively). ABD detected LV endocardial/blood borders in all six segments of each view in 73%, 72%, and 72% of cases, concordant with adequate two-dimensional imaging. Discrepancies between two-dimensional imaging and ABD were usually in the short-axis inferior and lateral, four-chamber lateral, and two-chamber anterior segments. There were 46 patients with normal LV wall motion and 22 with wall-motion abnormalities. The average time required to perform ABD was 375 seconds (range 180 to 780 seconds).(ABSTRACT TRUNCATED AT 250 WORDS)