P468Simultaneous assessment of left ventricular volumes, ejection fraction and myocardial deformation parameters in contrast echocardiograms.


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Abstract

Background: Contrast echocardiography (CE) provides better accuracy and closer agreement with cardiac magnetic resonance (MR) than native echocardiography for assessment of left ventricular (LV) volumes and ejection fraction (EF). However, processing of CE images for assessment of myocardial strain parameters has been limited by multiple artifacts. We evaluated a new software tool for assessment of LV function which provides simultaneous measurements of LV volumes, EF, and myocardial deformation parameters on CE recordings.Methods: In this pilot study, 53 consecutive patients recruited for the Alberta Heart Study (mean age 64±9 years,34 men) and undergoing CE and CMR were included. Contrast bolus injections were administered for optimal endocardial definition. Off-line LV volume analysis was performed by standard manual tracing of endsystolic and enddiastolic endocardial borders. Simultaneous LV volumes, EF and myocardial strain parameters (longitudinal and radial) were evaluated also by manual tracing of a single frame with a new software. LV volumes and EF were then compared with those measured with CMR and standard CE.Results: Manual tracing of CE images was possible in all 53 patients. Simultaneous processing for volumes and strain parameters by the new software was not successful in 3 patients, in whom visually >0.5 cm deviation of the computed tracking contour from the myocardial borders was found. Apical contrast destruction, contrast swirling and myocardial opacification impaired semiautomatic border detection. In 50 out of 53 patients (94%) the tracking contour followed the myocardial movements. The parameters obtained with the new software correlated well to both standard CE and CMR for all parameters: EDV (r 0.93, p<0.00001: r 0.91, p<0.00001 respectively), ESV (r 0.89, p<0.0000001: r 0.94, p<0.00001 respectively), and EF (r 0.87, p<0.0000001: r 0.83, p<0.0000001 respectively). Mean longitudinal and radial strain values were -14.51±2.1 and 45.35±3.4 respectively.Conclusions: Simultaneous processing of CE images for LV, EF and strain appears to be feasible as long there is homogenous LV opacification and low myocardial opacification. ESV, EDV and EF derived from the new software compare well with those obtained from standard CE and CMR.

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