The Clinical Benefits of Adding a Third Dimension to Assess the Left Ventricle with Echocardiography

Table 1

Left ventricular assessment by 3DE.

Advantages	Limitations
(i) From a 3D data set, 2D planes can be easily realigned after the acquisition to identify LV maximum longitudinal axis avoiding apical foreshortening and optimizing volumetric quantification	(i) Accurate semiautomated or fully automated LV quantitation can only be performed on good image quality data sets usually obtained in 80–85% of routine patients
(ii) 3DE measurements of left ventricular volumes are independent of geometric assumptions about its shape	(ii) To avoid stitching artifacts, regular cardiac rhythm and patient cooperation for breath holding are essential (i.e., 3DE cannot be used in patients with irregular atrial fibrillation or frequent ectopic beats, and severely dyspnoeic or clinically unstable patients)
(iii) From a single 3D full-volume data set, the operator can quickly obtain a comprehensive assessment of LV geometry and function (volumes, sphericity, ejection fraction, regional wall motion, dyssynchrony, strain in 4 dimensions, and mass)	(iii) The intervendor consistency of 3D quantitative parameters remains an unresolved issue
(iv) When compared to cardiac magnetic resonance, 3DE is more accurate and reproducible than 2DE in assessing LV geometry (volumes, mass, and shape) and function	(iv) The relatively low temporal resolution of 3DE limits the assessment of regional wall motion during exercise and dobutamine stress echo
(v) From a 3DE data set of the left ventricle, both qualitative and quantitative assessment of regional wall motion can be obtained in a faster, more accurate, and comprehensive manner in comparison with 2DE