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PubMed1999

[Superiority of second harmonic imaging for echocardiographic measurement of lef ventricular volumes. Comparison with angiocardiography].

Analysis of left ventricular volumes is a prognostic factor in cardiovascular disease. Echocardiography is a means of obtaining these parameters but is limited by poor reproducibility. Recently, a new echocardiographic technique, second harmonic imaging (SHI), developed through contrast agent methods, significantly improved the quality of imaging. The aim of this study was to demonstrate the value of SHI for assessing left ventricular volumes. Thirty patients admitted for cardiovascular evaluation and requiring angiocardiography underwent echocardiography with calculation of end diastolic (EDV) and end systolic volumes (ESV) of the left ventricle in fundamental (FI) and second harmonic (SHI) imaging. These measurements were compared with those of angiocardiography. The reproducibility of SHI was calculated after repetition of the measurements by two independent observers for both echocardiographic modes. There was a significant improvement of the parameters of linear regression in SHI compared with FI both for EDV (r = 0.93 versus 0.76) and for ESV (r = 0.94 versus 0.83), the reproducibility was also significantly improved in SHI (relative error of 5% versus 12% for intra-observer error and 6% versus 13% for inter-observer error). The authors conclude that SHI significantly improves two-dimensional imaging and provides a reliable and reproducible measurement of left ventricular volumes.

Adult↗
PubMed1992

Estimation of right ventricular volume by modified echocardiographic subtraction method.

To evaluate the accuracy and clinical utility of right ventricular volume estimated by a modified echocardiographic subtraction method versus Krebs' original subtraction method, an experiment was performed on hearts excised from 25 animals (dogs, pigs, and cows) followed by a clinical study of 41 patients with heart disease. Right ventricular volume was measured by subtracting the left ventricular volume from that of the whole heart based on echocardiographic apical two- and four-chamber views by means of the area-length method. In the animal heart study, the coefficient of variation between the right ventricular volume estimated by the modified method and the true volume was +/- 13%. The regression equation was y = 0.94x + 4.15 (r = 0.987, p less than 0.001) and showed good correlation, whereas the right ventricular volume obtained by the original method underestimated the true volume (coefficient of variation = +/- 25%, y = 0.59x + 1.11; r = 0.976, p less than 0.001). In the clinical study, the coefficient of variation between right ventricular volume estimated by the modified echocardiographic method and RV volume estimated by radionuclide ventriculography was +/- 15%. The regression equation was y = 0.80x + 13.3 (r = 0.935, p less than 0.001). This correlation was better than that obtained by the original method (coefficient of variation = +/- 16%), where the regression equation was y = 0.60x + 2.43 (r = 0.888, p less than 0.001). Thus the accuracy of the modified subtraction method was validated, and this method showed a better correlation than the original method both experimentally and clinically.

Adolescent↗
PubMed2004

Impact of papillary muscles in ventricular volume and ejection fraction assessment by cardiovascular magnetic resonance.

Cardiovascular magnetic resonance (CMR) is an accurate tool for the determination of right and left ventricular volumes and ejection fractions. However, the current standard short-axis technique is time-consuming and thus, often not practicable for routine daily use, because papillary muscles and trabeculations have to be marked and their volumes subtracted from the total ventricular volume. To reduce calculation time we evaluated the volumetric data that included papillary muscle and trabecular volumes and compared the outcome with the results of the standard technique. Thirty patients (17 healthy, 13 with coronary heart disease) were examined by CMR using TrueFISP (Magnetom, Siemens, Erlangen, Germany). Right and left ventricular volumes and ejection fractions were calculated using the standard short-axis technique and then again without subtracting papillary and trabecular volumes. The two methods were compared by determining the differences in results for ventricular volumes and ejection fractions. Statistically significant differences were found between the two methods for right and left ventricular stroke volumes and end-systolic volumes, and left ventricular end-diastolic volumes (EDV) (p < or = 0.011). No significant difference was found for right ventricular end-diastolic volumes (p > or = 0.149) or left or right ventricular ejection fraction (p > or = 0.130). Except in the case of left ventricular EDV, the deviations in the results of method 1 and method 2 did not vary significantly with the presence or absence of heart disease. Measurements were obtained considerably more quickly with the modified method than with the standard short-axis method (25 +/- 4 min vs. 13 +/- 3 min, p = 0.000). Although systematic differences were found when papillary and trabecular volumes were not subtracted, these differences are small and may not be of clinical relevance in healthy subjects or patients with coronary heart disease. Not subtracting the volumes of these structures enables faster determination of right and left ventricular volumes and ejection fractions without loss of the accuracy associated with the standard short-axis technique.

Adult↗
PubMedDate not supplied

Conductance-echocardiography correlation during changes in left ventricular volume.

Conductance (COND) measurements of left ventricular volume, satisfactory under steady state conditions, may be altered by extraneous factors during complex experiments or cardiac surgery. A reference technique is needed to detect changes in the COND-left ventricular volume relationship. This technique should indicate when recalibration of COND is needed. Accordingly, we assessed the relationship between left ventricular COND and the area of left ventricular short-axis cross section (SACS) by two-dimensional echocardiography during vena caval occlusion. Thirteen anesthetized pigs underwent a median sternotomy and insertion of a COND catheter. Two-dimensional echocardiography and COND were displayed and recorded simultaneously on a digital video monitor. Data were analyzed at end-diastole during the filling phase after vena caval occlusion, because the quality of two-dimensional echocardiography was better during recovery. Results demonstrated a linear relationship between left ventricular COND and SACS at end-diastole, with a positive slope. Correlation coefficients ranged from 0.88 to 1.0 and averaged 0.96 +/- 0.01 (SE). The overall mean relationship was (SACS) = 0.40 (COND) - 17. It is concluded that SACS by two-dimensional echocardiography can be employed to confirm COND measurements of left ventricular end-diastolic volume during laboratory experiments or cardiac surgery. Stability of the SACS-COND relationship indicates that COND calibration is valid. Changes in the SACS-COND relationship would require recalibration of COND. Data markedly deviating from a linear SACS-COND relation reflect experimental error and should be discarded.

Animals↗
PubMed2000

Large CSF volume not attributable to ventricular volume in schizotypal personality disorder.

OBJECTIVE: The purpose of this study was to determine whether schizotypal personality disorder, which has the same genetic diathesis as schizophrenia, manifests abnormalities in whole-brain and CSF volumes. METHOD: Sixteen right-handed and neuroleptic-naive men with schizotypal personality disorder were recruited from the community and were age-matched to 14 healthy comparison subjects. Magnetic resonance images were obtained from the subjects and automatically parcellated into CSF, gray matter, and white matter. Subsequent manual editing separated cortical from noncortical gray matter. Lateral ventricles and temporal horns were also delineated. RESULTS: The men with schizotypal personality disorder had larger CSF volumes than the comparison subjects; the difference was not attributable to larger lateral ventricles. The cortical gray matter was somewhat smaller in the men with schizotypal personality disorder, but the difference was not statistically significant. CONCLUSIONS: Consistent with many studies of schizophrenia, this examination of schizotypal personality disorder indicated abnormalities in brain CSF volumes.

Adult↗
PubMed2002

Ventricular volume change in childhood.

OBJECT: The aim of this study was to construct a model of age-related changes in ventricular volume in a group of normal children ages 1 month to 15 years, which could be used for comparative studies of cerebrospinal fluid circulation disorders and cerebral atrophy developmental syndromes. METHODS: A magnetic resonance imaging-based segmentation technique was used to measure ventricular volumes in normal children; each volume was then plotted against the child's age. In addition, intracranial volumes were measured and the ratio of ventricular to intracranial volume was calculated and plotted against age. The study group included 71 normal children, 39 boys and 32 girls, whose ages ranged from 1 month to 15.3 years (mean 84.9 months, median 79 months). The mean ventricular volume was 21.3 cm3 for the whole group, 22.7 cm3 in boys and 19.6 cm3 in girls (p = 0.062, according to t-tests). The mean ventricular volume at 12 months for the whole group was 17 cm3 (20 cm3 in boys and 15 cm3 in girls), representing 65% of the volume achieved by 15 years of age (87% in boys and 53% in girls). The volume increased by a factor of 1.53, to 26 cm3 (23 cm3 in males and 28 cm3 in females, increase factors of 1.15 and 1.86, respectively) at 15 years of age. The change in ventricular volume with age is not linear, but follows a segmental pattern. These age periods were defined as: 0 to 3, 4 to 6, 7 to 10, and 11 to 16 years. A statistical difference based on sex was only demonstrated in the first 6 years of life. The mean ventricular volume for the first 6-year period was 22.4 cm3 in boys and 15.7 cm3 in girls, and the difference was significant for the two sexes (linear regression analysis for age and sex, significant according to analysis of variance regression at 0.007, p = 0.108 for age, p = 0.012 for sex). Thereafter, there was no significant difference in ventricular volume between boys and girls with further growth. The ratio of ventricular volume to intracranial volume was 0.0175 for the whole group, 0.017 in boys and 0.018 in girls (p = 0.272, according to t-tests). At 12 months of age the ratio was 0.019; it stabilized to 0.015 at 8 years of age, and increased to 0.018 at 15 years of age. No statistical difference based on sex was demonstrated with growth. CONCLUSIONS: The ventricular volume in normal children increases with age by a factor of 1.5; the increase is in a nonlinear segmental pattern. Boys have significantly higher ventricular volumes only in the first 6 years of life. The ventricular/intracranial volume ratio remains stable throughout childhood.

Adolescent↗
PubMed2005

Increased plasma levels of natriuretic peptide type B and A in children with congenital heart defects with left compared with right ventricular volume overload or pressure overload.

AIM: Natriuretic peptide levels B (BNP) and A (ANP) have been described in children with congenital heart defects (CHD) with pressure and volume overload. However, the impact of ventricular morphology per se on natriuretic peptide levels has not been reported. The aim of the present study was to evaluate plasma BNP and ANP in children with CHD with left or right ventricular volume or pressure overload. METHODS AND RESULTS: Plasma BNP and ANP were analysed in 61 children, median age 3.1 (0.3-16.2) years. Haemodynamic load was evaluated by echo-Doppler and/or catheterization measurements and classified as: pressure overload of the right (RV pressure) or left (LV pressure) ventricle, or volume overload of the right (RV volume) or left (LV volume) ventricle, of a sufficient degree to indicate surgery/catheter intervention. Twenty-three children, with a median age of 1.1 (0.1-8.3) years, without heart disease, served as controls for the natriuretic peptide measurements. Children in the LV volume group had significantly higher BNP and ANP values, 55.4 ng l-1 (10.7-352) and 164 (31.8-346), than children in the RV volume, 15.6 (0.0-105.1) and 57.2 (11.3-234.1), LV pressure, 6.8 (0.7-170) and 40.8 (12.6-210), and RV pressure, 18.0 (5.0-29.1) and 69.3 (8.7-182), groups respectively (P<0.0001). The values in the LV pressure group were close to the values in the Control group, 4.7 (0.0-17.7) and 32.9 (11.7-212.1), respectively (P=0.051 and P=0.378, respectively). CONCLUSIONS: Plasma concentrations of BNP and ANP were higher in children with CHD with left ventricular volume overload compared with right ventricular volume overload or pressure overload.

Adolescent↗
PubMed2000

Periventricular leukomalacia: relationship between lateral ventricular volume on brain MR images and severity of cognitive and motor impairment.

PURPOSE: To evaluate the utility of lateral ventricular volume measurements in predicting motor and cognitive impairment severity in children with periventricular leukomalacia (PVL), with or without seizures. MATERIALS AND METHODS: The charts of children with spastic cerebral palsy and PVL documented on brain magnetic resonance (MR) images were reviewed. Affected children were grouped by motor and cognitive impairment severity and seizure disorder. An age-matched control group was established. Lateral ventricular volumes were measured on two-dimensional T2-weighted spin-echo MR images. Analysis of variance was used to identify significant differences in mean lateral ventricular volume between groups. Paired analyses of differences were performed with the Bonferroni t method. RESULTS: Thirty-six children (24 boys, 12 girls) with spastic cerebral palsy and PVL and 21 age-matched control subjects (14 boys, seven girls) were identified. Mean lateral ventricular volumes of the moderate and marked motor deficit groups were significantly larger than those of the control and mild motor deficit groups (F = 29.24; alpha = .01). Mean lateral ventricular volumes of all cognitive impairment groups were significantly larger than those of the control and no-cognitive-impairment groups (F = 21.101 alpha = .01). There was no difference in mean lateral ventricular volume between children with PVL with or without seizures. CONCLUSION: Lateral ventricular volume measurements can be used as quantitative markers of clinical impairment severity and as clinical outcome predictors before formal testing is possible.

Brain Damage, Chronic↗
PubMed1994

Three-dimensional echocardiography. In vivo validation for right ventricular volume and function.

BACKGROUND: Current two-dimensional echocardiographic measures of right ventricular volume are limited by the asymmetrical and crescentic shape of the ventricle and by difficulty in obtaining standardized views. Three-dimensional echocardiographic reconstruction, which does not require geometric assumptions or standardized views, may therefore have potential advantages for determining right ventricular volume. Three-dimensional techniques, however, have not been applied to the right ventricle in vivo, where cardiac motion and contraction could affect accuracy. The purpose of this study was to determine the feasibility and accuracy of three-dimensional echocardiographic reconstruction for quantifying right ventricular volume and function in vivo. In particular, it was designed to test the accuracy of a newly developed system that provides rapid, efficient, and automated three-dimensional data collection (minimizing motion effects) and takes advantage of the full three-dimensional data set to obtain volume. METHODS AND RESULTS: The three-dimensional system was applied to reconstruct the right ventricle and measure its volume and function during 20 hemodynamic stages created in five dogs. Actual instantaneous volumes were measured continuously by an intracavitary balloon connected to an external column. Hemodynamics were varied by volume loading and induction of ischemia. Three-dimensional reconstruction successfully reproduced right ventricular volume compared with actual values at end diastole (y = 1.0 chi-3.4, r = .99, SEE = 1.8 mL) and end systole (y = 1.0 chi+ 2.0, 4 = .98, SEE = 2.5 mL). The mean difference between calculated and actual volumes throughout the cycle was 2.1 mL, or 4.9% of the mean. Ejection fraction also correlated well with actual values (y = 0.96 chi-0.3, r = .98, SEE = 3.3%). CONCLUSIONS: Despite the irregular crescentic shape of the right ventricle, this newly developed three-dimensional system and surfacing algorithm can accurately reconstruct its shape and quantitate its volume and function in vivo without geometric assumptions. The increased efficiency of the system should increase applicability to issues of clinical and research interest.

Algorithms↗
PubMed1984

Attenuation correction of equilibrium radionuclide angiography for noninvasive quantitation of cardiac output and ventricular volumes.

Gated equilibrium radionuclide angiography (RNA) provides count information which is proportional to ventricular volumes. In order to convert ventricular count data directly to accurate absolute volumes, we performed attenuation correction on equilibrium radionuclide angiograms by means of a simple geometric method of attenuation distance quantitation. Attenuation distance defined during imaging agreed with similar measurements obtained during fluoroscopy (r = 0.86). In seven patients, 23 simultaneous cardiac output determinations by Fick and radionuclide imaging techniques showed excellent correlation over a wide range of cardiac outputs (r = 0.91). Radionuclide angiographic ventricular volumes correlated with contrast angiographic ventricular volumes in 28 patients (r = 0.80). The weaker correlation found for ventricular volume data may be due to inaccuracies in ventricular volume calculation when single-plane contrast angiography is applied to patients with wall motion abnormalities. We conclude that attenuation-corrected RNA allows direct calculation of cardiac output and ventricular volumes in individual patients without use of regression equations.

Cardiac Catheterization↗
PubMed1983

Three dimensional reconstruction of the left ventricle from multiple cross sectional echocardiograms. Value for measuring left ventricular volume.

The accuracy of a system for reconstructing a three dimensional image of the left ventricle from randomly recorded multiple short axis images was tested by comparing the calculated left ventricular volume with the directly measured left ventricular volume in 11 excised porcine hearts. The system comprised a real time phased array sector scanner, a transducer locating system, and a computer system for digitising outlines of the left ventricle, displaying the reconstruction image, and calculating the left ventricular volume. The reconstructed image was similar to the real image and the calculated left ventricular volume showed a high correlation with the directly measured left ventricular volume. This method was accurate in vitro and is expected to be available for clinical measurement of left ventricular volume.

Animals↗
PubMed2005

Magnetic resonance imaging during untreated ventricular fibrillation reveals prompt right ventricular overdistention without left ventricular volume loss.

BACKGROUND: Most out-of-hospital ventricular fibrillation (VF) is prolonged (>5 minutes), and defibrillation from prolonged VF typically results in asystole or pulseless electrical activity. Recent visual epicardial observations in an open-chest, open-pericardium model of swine VF indicate that blood flows from the high-pressure arterial system to the lower-pressure venous system during untreated VF, thereby overdistending the right ventricle and apparently decreasing left ventricular size. Therefore, inadequate left ventricular stroke volume after defibrillation from prolonged VF has been postulated as a major contributor to the development of pulseless rhythms. METHODS AND RESULTS: Ventricular dimensions were determined by MRI for 30 minutes of untreated VF in a closed-chest, closed-pericardium model in 6 swine. Within 1 minute of untreated VF, mean right ventricular volume increased by 29% but did not increase thereafter. During the first 5 minutes of untreated VF, mean left ventricular volume increased by 34%. Between 20 and 30 minutes of VF, stone heart occurred as manifested by dramatic thickening of the myocardium and concomitant substantial decreases in left ventricular volume. CONCLUSIONS: In this closed-chest swine model of VF, substantial right ventricular volume changes occurred early and did not result in smaller left ventricular volumes. The changes in ventricular volumes before the late development of stone heart do not explain why defibrillation from brief duration VF (<5 minutes) typically results in a pulsatile rhythm with return of spontaneous circulation, whereas defibrillation from prolonged VF (5 to 15 minutes) does not.

Animals↗
PubMed1992

Value and limitations of transesophageal echocardiography in determination of left ventricular volumes and ejection fraction.

Several formulas exist for estimating left ventricular volumes and ejection fraction using conventional two-dimensional echocardiography from transthoracic views. Transesophageal imaging provides superior resolution of endocardial borders but employs slightly different scan planes. The estimation of left ventricular volumes by transesophageal echocardiography has not been validated in human patients. Therefore, the purpose of this study was to compare left ventricular volumes and ejection fraction derived from transesophageal short-axis and four-chamber images with similar variables obtained from ventriculography. End-diastolic and end-systolic volumes and ejection fraction were calculated using modified Simpson's rule, area-length and diameter-length models in 36 patients undergoing left ventriculography. Measurements of left ventricular length were obtained from the transesophageal four-chamber view and areas and diameters were taken from short-axis scans at the mitral valve, papillary muscle and apex levels. Data from transesophageal echocardiographic calculations were compared with end-diastolic volume (mean 172 +/- 90 ml), end-systolic volume (mean 91 +/- 74 ml) and ejection fraction (mean 52 +/- 15%) from cineventriculography using linear regression analysis. The area-length method (r = 0.88) resulted in a slightly better correlation with left ventricular end-diastolic volume than did Simpson's rule (r = 0.85) or area-length (r = 0.84) formulas. For end-systolic volume, the three models yielded similar correlations: Simpson's rule (r = 0.94), area-length (r = 0.93) and diameter-length (r = 0.95). Each of the methods resulted in significant underestimation of diastolic and systolic volumes compared with values assessed with angiography (p less than 0.003). Ejection fraction was best predicted by using the Simpson's rule formula (r = 0.85) in comparison with area-length (r = 0.80) or diameter-length (r = 0.73) formulas. Measurements of left ventricular length by transesophageal echocardiography were smaller for systole (mean 5.7 +/- 1.6 cm) and diastole (mean 7.7 +/- 1.2 cm) than values by ventriculography (mean 9.2 +/- 1.4 and 8.1 +/- 1.6 cm, respectively; p less than 0.0001), suggesting that underestimation of the ventricular length is a major factor contributing to the smaller volumes obtained by transesophageal echocardiography. In conclusion, currently existing formulas can be applied to transesophageal images for predicting left ventricular volumes and ejection fraction. However, volumes obtained by these models are significantly smaller than those obtained with angiography, possibly because of foreshortening in the transesophageal four-chamber view.

Adult↗
PubMed1998

[Assessment of left ventricular volume by contrast echocardiography].

Two-dimensional echocardiography for measuring left ventricular volumes usually gives volumes that are smaller than those determined with left ventriculography. This is due to less optimal image quality since manual tracing of endocardial borders requires still frames. Intravenous injection of echocontrast agent (Albunex) improve endocardial border recognition and therefore left ventricular volume measurements become more accurate. It is reported that contrast echocardiography significantly improves the correlation of echocardiographic left ventricular volume measurement with that of left ventriculography. From this points of view, contrast echocardiography is useful for the determination of left ventricular volumes in clinical settings.

Albumins↗