ABSTRACT Purpose: The aim of the present study was to evaluate the diagnostic accuracy for quantification of left ventricular (LV) volumes and LV ejection fraction (LVEF) with current echocardiographic methods of planimetry for analysis of LV remodeling after myocardial infarction in daily clinical routine. Methods: 26 patients were investigated directly after interventional therapy at hospital pre-discharge and at 6 month follow-up. Standardized 2D transthoracic native and contrast echocardiography were performed in all patients. Due to methodological aspects the results of LV volumes and LVEF using native echocardiography were compared to the results of LV opacification (LVO) imaging for analysis in mono-, bi- and triplane data sets using the Simpson’s rule. In addition corresponding multidimensional data sets were analyzed. Results: The assessment of LV volumes and LVEF is more accurate with contrast echocardiography. The comparison of LV volumes and LVEF shows significant increases using contrast echocardiography (p < 0.001). Larger left ventricular end-diastolic volumes (LVEDV) are measured at follow up (p < 0.05). Significant differences (p < 0.001) are found for the determination of LVEDV and LVEF relating to apical mono-, bi-, tri- and multiplane data sets. Standard deviations of the triplane approach, however, are significantly lower than using other modalities. Conclusion: Depending on the localization of the myocardial infarction LV volumes and LVEF are less reliably evaluated using the mono- or biplane approach. According to standardization and simultaneous acquisition of all LV wall segments the triplane approach is currently the best approach to determine LV systolic function. In addition, contrast echocardiography is indicated to improve endocardial border delineation in patients using the triplane or multiplane approach. To our knowledge the present study is the first systematic evaluation of all current possibilities for determination of LV volumes and LVEF by native and contrast echocardiography.
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S. Stoebe, A. Tarr, T. Trache, J. Kluge and D. Pfeiffer, "Systematic Evaluation of Current Possibilities to Determine Left Ventricular Volumes by Echocardiography in Patients after Myocardial Infarction," Open Journal of Medical Imaging, Vol. 2 No. 2, 2012, pp. 68-75. doi: 10.4236/ojmi.2012.22012.
  S. Nayyar, A. Magalski, T. M. Khumri, M. Idupulapati, C. N. Stoner, L. L. Kusnetzky, T. R. Coggins, B. A. Morris and M. L. Main, “Contrast Administration Reduces Interobserver Variability in Determination of Left Ventricular Ejection Fraction in Patients with Left Ventricular Dysfunction and Good Baseline Endocardial Border Delineation,” The American Journal of Cardiology, Vol. 98, No. 8, 2006, pp. 1110-1114.
 K. Thygesen, J. S. Alpert and H. D. White, “Universal Definition of Myocardial Infarction,” European Heart Journal, Vol. 28, No. 20, 2007, pp. 2525-2538.
 The Joint European Society of Cardiology/American College of Cardiology Committee, “Myocardial Infarction Redefined—A Consensus Document of The Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction,” European Heart Journal, Vol. 21, No. 18, 2000, pp. 1502-1513. doi:10.1053/euhj.2000.2305
 R. M. Lang, M. Bierig, R. B. Devereux, F. A. Flachskampf, E. Foster, P. A. Pellikka, M. H. Picard, M. J. Roman, J. Seward, J. Shanewise, S. Solomon, K. T. Spencer, M. St. J. Sutton and W. Stewart, “Recommendations for Chamber Quantification,” European Journal of Echocardiography, Vol. 7, No. 2, 2006, pp. 79-108.
 J. J. Gajarsa and R. A. Kloner, “Left Ventricular Remodeling in the Post-Infarction Heart: A Review of Cellular, Molecular Mechanisms, and Therapeutic Modalities,” Heart Failure Reviews, Vol. 16, No. 1, 2011, pp. 13-21.
 M. Wong, L. Staszewsky, R. Latini, S. Barlera, R. Glazer, N. Aknay, A. Hester, I. Anand and J. N. Cohn, “Severity of Left Ventricular Remodeling Defines Outcomes and Response to Therapy in Heart Failure: Valsartan Heart Failure Trial (Val-HeFT) Echocardiographic Data,” Journal of the American College Cardiology, Vol. 43, No. 11, 2004, pp. 2022-2027. doi:10.1016/j.jacc.2003.12.053
 N. P. Nikolay, C. Constantin, P. H. Lo, J. Ghosh, E. I. Lukaschuk, A. Bennett, S. Hurren, F. Alamgir, A. L. Clark and J. G. F. Cleland, “New Generation 3-Dimensional Echocardiography for Left Ventricular Volumetric and Functional Measurements: Comparison with Cardiac Magnetic Resonance,” European Journal of Echocardiography, Vol. 7, No. 5, 2006, pp. 365-372.
 L. Agati, G. Tonti, L. Galiuto, V. D. Bello, S. Funaro, M. P. Madonna, B. Garramone and F. Magri, “Quantification Methods in Contrast Echocardiography,” European Journal of Echocardiography, Vol. 6, Suppl. 2, 2005, pp. S14S20. doi: 10.1016/S1525-2167(05)80724-3
 A. Hagendorff, “Transthoracic Echocardiography in Adult Patients—A Proposal for Documenting a Standardized Investigation,” Ultraschall in der Medizin, Vol. 29, No. 4, 2008, pp. 344-374. doi: 10.1055/s-2008-1027491
 D. Muraru, L. P. Badano, G. Piccoli, P. Gianfagna, L. del Mestre, D. Ermacora and A. Proclemer, “Validation of a Novel Automated Border-Detection Algorithm for Rapid and Accurate Quantitation of Left Ventricular Volumes Based on Three-Dimensional Echocardiography,” European Journal of Echocardiography, Vol. 11, No. 4, 2010, pp. 359-368. doi:10.1093/ejechocard/jep217
 M. J. Monaghan, “Role of Real Time 3D Echocardiography in Evaluating the Left Ventricle,” Heart, Vol. 92, No. 1, 2006, pp. 131-136. doi:10.1136/hrt.2004.058388
 R. Hoffmann, S. von Bardeleben, F. ten Cate, A. C. Borges, J. Kasprzak, C. Firschke, S. Lafitte, N. Al-Saadi, S. Kuntz-Hehner, M. Engelhardt, H. Becher and J. L. Vanoverschelde, “Assessment of Systolic Left Ventricular Function: A Multi-Centre Comparison of Cineventriculography, Cardiac Magnetic Resonance Imaging, Unenhanced and Contrast-Enhanced Echocardiography,” European Heart Journal, Vol. 26, No. 6, 2005, pp. 607-616.
 R. Olszewski, J. Timperley, S. Cezary, M. Monaghan, P. Nihoyannopoulis, R. Senior and H. Becher, “The Clinical Applications of Contrast Echocardiography,” European Journal of Echocardiography, Vol. 8, No. 3, 2007, pp. S13-S23. doi:10.1016/j.euje.2007.03.021
 K. Y. E. Leung and J. G. Bosch, “Automated Border Detection in Three-Dimensional Echocardiography: Principles and Promises,” European Journal of Echocardiography, Vol. 11, No. 2, 2010, pp. 97-108.
 H. F. J. Mannaerts, J. A. van der Heide, O. Kamp, M. G. Stoel, J. Twisk and C. A. Visser, “Early Identification of Left Ventricular Remodeling after Myocardial Infarction, Assessed by Transthoracic 3D Echocardiography,” European Heart Journal, Vol. 25, No. 8, 2004, pp. 680-687.
 V. Mor-Avi, L. Sugeng and R. M. Lang, “Real-Time 3-Dimensional Echocardiography: An Integral Component of the Routine Echocardiographic Examination in Adult Patients?” Circulation, Vol. 119, 2009, pp. 314-329.