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European Heart Journal 1998 19(5):808-816; doi:10.1053/euhj.1997.0852
Copyright © 1998 by the European Society of Cardiology.
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Quantitation of left ventricular volumes and ejection fraction in post-infarction patients from biplane and single plane two-dimensional echocardiograms. A prospective longitudinal study of 371 patients

St John SuttonM. af1, OtterstatJ.-E. b, T. Plapperta, A. Parkerc, D. Sekarskic, M.G. Keanea, P. Poole-Wilsond and K. Lubsenc

a Cardiovascular Division, University of Pennsylvania Medical Center, Philadelphia, PA, U.S.A.
b Division of Cardiology, Vestfold General Hospital, Toensberg, Norway
c SOCAR SA, Givrins, Switzerland
d Department of Cardiac Medicine, National Heart and Lung Institute, London, U.K.

accepted December 1, 1997

Aims

To determine whether left ventricular volumes and ejection fractions calculated from single plane two-dimensional echocardiograms using the algorithm (0·85A2L) correlate with those calculated using the biplane Simpson’s method, and whether small changes in volumes and ejection fraction occurring post-infarction could be detected from single-plane as well as from biplane two-dimensional echocardiograms.

Methods and Results

Serial two-dimensional echocardiograms were obtained in 371 patients from the DEFIANT II trial a mean of 2 days, 1 week and 6 months post-infarction. Single plane volumes from the apical four chamber and apical long axis correlated closely with biplane Simpson’s left ventricular volumes. Both single-plane left ventricular volumes significantly over-estimated biplane Simpson’s volumes. Biplane Simpson’s ejection fractions were consistently slightly under-estimated from the single-plane images. Differences between biplane Simpson’s and single-plane volumes increased independently with increasing left ventricular size and distortion. The small changes in left ventricular volumes and ejection fraction over time were as reliably detected from single plane as from biplane images.

Conclusion

Single-plane left ventricular volumes over-estimate biplane Simpson’s volumes and under-estimate ejection fraction, and these discrepancies are amplified in dilated hearts with abnormal shape.

Key Words: Left ventricular volumes • ejection fraction • echocardiography

f1 Correspondence: Martin St John Sutton, Division of Cardiology, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, U.S.A.


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