Evaluation of Midwall Systolic Function in Left Ventricular Hypertrophy: A Comparison of 3-Dimensional Versus 2-Dimensional Echocardiographic Indices

Hae Ok Jung, Florence H. Sheehan, Edward L. Bolson, Mary Pierre Waiss, Catherine M. Otto

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Objective: This study investigated the sensitivity of 3-dimensional (3D) midwall ejection fraction (EF) (3DEFmw) to the presence of left ventricular (LV) hypertrophy (LVH) in comparison with conventional echocardiographic indices for systolic function. Background: EF and fractional shortening (FS) do not reflect the prognosis of patients with LVH. Midwall mechanics better represent the true function in LVH. However, midwall FS (FSmw) interrogates a limited region of LV. We developed a method for determining 3DEFmw. Methods: This study compared 3DEFmw with 2-dimensional (endocardial EF [EFendo], endocardial FS, FSmw, and systolic tissue velocity) and 3D (3D EFendo and mitral annular motion [MAM]) echocardiographic indices in 28 patients with essential hypertension and LV mass index by M-mode greater than 125 g/m2 versus 21 healthy individuals. Results: Systolic function assessed by EFendo, endocardial FS, 3D EFendo, and systolic tissue velocity did not differ between the two groups, but MAM (11.6 vs 14.0 mm), FSmw (14.7 vs 18.2%), and 3DEFmw (36.6 vs 44.1%) were significantly decreased in LVH compared with normal. Only 3 parameters correlated significantly with both the M-mode and 3D measurements of LV mass index: FSmw (r = -0.74 [M-mode]; r = -0.48 [3D]), 3DEFmw (r = -0.63 [M-mode]; r = -0.68 [3D]), and MAM (r = -0.43 [M-mode]; r = -0.36 [3D]). Midwall indices FSmw (F = 40.4) and 3DEFmw (F = 26.5) better discriminated LVH and normal groups than MAM or endocardial indices. Conclusions: The 3DEFmw method discriminates the systolic function of LVH and normal groups, and correlates with the degree of hypertrophy. By avoiding the limitations of FSmw or MAM, 3DEFmw provides a more comprehensive metric of systolic function in patients with LVH.

Original languageEnglish
Pages (from-to)802-810
Number of pages9
JournalJournal of the American Society of Echocardiography
Volume19
Issue number6
DOIs
StatePublished - Jun 2006

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